Determination of Vaccination Status of 2nd and 3rd Trimester Pregnant Women Registered to Family Physicians in the Central Districts of Antalya Province Against Covid-19 and Reasons for Vaccination Hesitation

Abstract

Objective: Although the risk of Covid-19 in pregnant women is similar to that of the general population, they have a higher risk of developing serious diseases compared to non-pregnant women of similar age. The aim of the study was to determine the vaccination status of pregnant women against Covid-19 and the reasons for vaccination hesitation. Method: The study is cross-sectional. It was conducted between 01/12/2021-30/06/2022. Family physicians in the central districts were selected by simple random sampling to reach the calculated number of participants. The dependent variable of the study was Covid-19 vaccination status; the independent variables were educational status, income status, Covid-19 exposure and vaccination status, Covid-19 vaccination recommendation while pregnant, if recommended, who recommended it, and reasons for not getting vaccinated. Analyses were performed in SPSS 23.0 programme. Chi-square and Student t test were used in univariate analyses. Logistic regression was used in multivariate analyses; p<0.05 was considered significant. Results: 67.8% of the pregnant women were reached (n=198). The mean age of the participants was 29.01±5.53 years; 61.4% were in the last trimester of pregnancy; 12.2% had a chronic disease. Since the beginning of the pandemic, 31.2% of pregnant women had Covid-19; 35% of them had Covid-19 while pregnant. 74.2% of pregnant women received at least one dose of Covid-19 vaccine; 42.3% of those vaccinated were vaccinated while pregnant. 25.2% of pregnant women were not vaccinated; 20.7% were not offered Covid-19 vaccine. Among the unvaccinated pregnant women, the two most frequently cited reasons for not being vaccinated were fear of side effects (51.1%) and fear of the possibility of adverse effects on the baby (24.4%). According to the results of multivariate analysis, not getting Covid-19 vaccine was found to be 8.35 times higher in pregnant women for whom vaccination was not recommended (p=.001; 95% CI: 2.40-28.98). Conclusion: 25.8% of pregnant women were not vaccinated during pregnancy and 20.7% were not offered any vaccine. A significant number of pregnant women and their babies are still at risk. In a high-risk situation such as a pandemic, pregnant women should be closely monitored and a 'zero tolerance' approach should be adopted. In order to increase vaccination, it is of great importance for healthcare professionals to recommend the vaccine.

Keywords

• COVID-19
• COVID-19 vaccine
• Pandemic
• Pregnancy

Antalya İli Merkez İlçelerindeki Aile Hekimlerine Kayıtlı, İkinci ve Üçüncü Trimesterdaki Gebelerin COVID-19’a Karşı Aşılanma Durumlarının ve Aşı Tereddütü Sebeplerinin Belirlenmesi

Öz

Amaç: Gebelerin Covid-19’a yakalanma riski toplumla benzer olsa da benzer yaştaki gebe olmayan kadınlara göre ciddi hastalık geliştirme riskleri bulunmaktadır. Çalışmanın amacı; gebelerin Covid-19’a karşı aşılanma durumları, aşı tereddüdü sebeplerinin belirlenmesidir. Yöntem: Çalışma kesitsel tiptedir. Çalışma 01/12/2021-30/06/2022 tarihleri arasında yürütülmüştür. Hesaplanan katılımcı sayısına ulaşmak için merkez ilçelerdeki aile hekimleri basit rastgele örneklemeyle seçilmiştir. Çalışmanın bağımlı değişkeni Covid-19 aşısı olma durumu; bağımsız değişkenleri eğitim durumu, gelir durumu, Covid-19 geçirme ve aşılanma durumu, gebeyken Covid-19 aşısının önerilme durumu, önerildiyse kimin önerdiği, aşı yaptırmama nedenleridir. Analizler, SPSS 23.0 programında yapılmıştır. Tek değişkenli analizlerde Ki-kare ve Student t testi kullanılmıştır. Çok değişkenli analizde lojistik regresyon kullanılmış; p<0,05 anlamlı kabul edilmiştir. Bulgular: Gebelerin %67,8’ ine ulaşılmıştır (n=198). Katılımcıların yaş ortalaması 29,01±5,53’tür; %61,4’ü gebeliğin son trimesterindedir; %12,2’sinin bir kronik hastalığı vardır. Pandeminin başından beri gebelerin %31,2’si Covid-19 geçirmiştir; bunların %35’i Covid-19’u gebeyken geçirmiştir. Gebelerin %74,2’si en az bir doz Covid-19 aşısı yaptırmış; aşılananların %42,3’ü gebeyken aşılanmıştır. Gebelerin %25,2’si aşılanmamıştır; %20,7’sine Covid-19 aşısı önerilmemiştir. Aşılanmayan gebelerden, aşılanmama nedenini belirtenlerin en sık belirttiği iki neden; yan etkilerinden korkmak (%51,1), bebeğin olumsuz etkilenme ihtimalinden korkmaktır (%24,4). Çok değişkenli analiz sonucuna göre aşı önerilmeyen gebelerde Covid-19 aşısı yaptırmama 8,35 kat fazla bulunmuştur (p=,001; %95 GA:2,40-28,98). Sonuç: Gebelerin %25,8’i, gebelik döneminde aşılanmamış; %20,7’sine hiç aşı önerilmemiştir. Hâlâ ciddi sayıda gebe ve bebeği risk altındadır. Pandemi gibi yüksek riskli bir durumda; gebeler yakından takip edilmeli, aşısız olmalarına ‘sıfır tolerans’ yaklaşımı benimsenmelidir. Aşılanmanın arttırılabilmesi için sağlık çalışanlarının aşıyı önermesinin önemi büyüktür.

Anahtar Kelimeler

• COVID-19
• COVID-19 aşısı
• Pandemi
• Gebelik

Kaynakça

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