•Vaccine uptake was significantly higher in foreign-born individuals.•Increased educational attainment was associated with higher vaccine uptake.•There was a difference in vaccine uptake between ...White and Black individuals.•Insurance status did not influence vaccine uptake.
To identify discrepancies in influenza, Tdap, and COVID-19 vaccine uptake and offer rates among pregnant individuals across various social determinants of health including race, ethnicity, foreign-born status, education level, and health insurance coverage, highlighting potential interventions to improve vaccine uptake in pregnancy.
An IRB-approved cross-sectional survey was conducted on the postpartum floor of a large urban hospital in South Florida. Between July to September 2021, 359 participants consented and answered questions on their demographics, social background, and influenza, Tdap, and COVID-19 vaccine history.
Most participants identified as White (67.7 %), Hispanic (67.4 %), and foreign-born (68.5 %) with an average age of 29.7 ± 6 years. There was a significant difference in mean vaccine between White (1.3) and Black individuals (0.9, p = 0.002). Mean uptake was significantly higher in foreign-born individuals (1.3) compared to US-born (0.9, p < 0.001). Mean uptake was significantly higher for those with graduate (1.7) and college (1.4) degrees compared to those with a high school degree (1.0) or less than high school (1.0, p < 0.0001).
Significant differences in the uptake and offer rates of influenza, Tdap, and COVID-19 vaccines were observed across a variety of social determinants including educational attainment, employment, insurance, and median income of the zip code of primary residence.
Abstract
Lynch Syndrome (LS) prevalence in underrepresented minorities are lacking. The objective of this study was to assess the prevalence of LS in a minority patient population. Secondary ...objectives included identifying factors associated with successful LS screening and to characterize clinicopathologic features. Women with endometrial cancer treated within a university system from 2014 and 2016 were included. Immunohistochemistry (IHC) results of MLH1, PMS2, MSH2 and MSH6 were obtained from medical records and clinicopathologic factors abstracted. Patients not previously screened for LS were screened. 276 patients were evaluable. More minority women were screened as part of their routine cancer care (p = 0.005). Additionally, women 50 years or younger were more likely to be screened for LS compared to women older than 51(p = 0.009) and uninsured or reliant on Medicaid patients (p = 0.011) were more likely to be screened during routine care. Six patients received confirmatory germline testing for LS (4.3%), and another 8 patients had a staining pattern suggestive of LS. In an underrepresented population, the rate of LS in endometrial cancer is similar to previous reports. LS may be under diagnosed and opportunities missed when universal screening is not applied in minority women.
INTRODUCTION:
Immunization plays an essential role in protecting the mother and child dyad from serious illnesses. Despite current recommendations from the American College of Obstetricians and ...Gynecologist, Advisory Committee on Immunization Practices, and Centers for Disease Control and Prevention, vaccination rates in the U.S. are significantly below 100%. The aim of this study is to assess uptake of influenza, Tdap, and COVID-19 vaccination in pregnancy among a culturally diverse population in South Florida.
METHODS:
An institutional review board‒approved cross-sectional survey was administered among inpatient postpartum persons between July and September 2021. The 359 enrolled participants completed a survey assessing basic demographics and vaccination history. Chi-square tests, set at a significance level of
P
<.05, compared uptake of each vaccine by ethnicity and U.S.-born status.
RESULTS:
Of the 359 participants, 67.7% self-identified as White, 67.4% reported Hispanic ethnicity, and 68.5% were non-U.S.-born. Compared to the 2019–2020 national average, Tdap vaccine uptake in this cohort was higher (74.7% versus 56.6%) and influenza vaccine uptake was lower (45.1% versus 61.2%). COVID-19 vaccine uptake during the study period mirrored the national average (18.1% versus 18.9%). Generally, there was higher vaccination uptake among Hispanics and non-U.S.-born individuals. However, a significant difference was only observed for uptake in influenza vaccine between U.S.-born and non-U.S.-born persons (chi-square=11.54,
P
=.0007).
CONCLUSION:
The suboptimal rates of influenza, Tdap, and COVID-19 vaccination seen in this cohort demonstrate the necessity for interventions to improve education about the safety and effectiveness of vaccination in pregnancy. Furthermore, increased efforts to maximize availability and access to vaccines during prenatal care are also needed. Together, these strategies may increase vaccine uptake in pregnancy, especially across diverse populations.
INTRODUCTION:
Immunization against SARS-COV-2 protects pregnant persons from severe COVID-19 illness. Pregnant individuals are less likely (19.2%) to be vaccinated against COVID-19 than their ...non-gravidas counterparts (69.6%). This disparity may be attributed to a lack of knowledge regarding the risks of SARS-COV-2 infection in pregnancy and the benefits and safety of vaccination. This study aims to determine the impact of patients’ self-reported COVID-19 knowledge on COVID-19 vaccination rates during pregnancy.
METHODS:
A total of 359 postpartum patients consented to participate in an institutional review board‒approved cross-sectional survey at an urban academic medical center in Miami, Florida between July and September 2021. Participants self-reported their COVID-19 vaccination status and answered questions to assess their general knowledge regarding COVID-19 infection and its impact on pregnancy, as well as knowledge of current guidelines for vaccination in pregnancy and safety of vaccination in pregnancy and breastfeeding. Correct responses to each item earned 1 point, while incorrect responses detracted 1 point, yielding knowledge scores ranging from –5 to +5.
RESULTS:
The mean knowledge score across participants was 1.7±1.77. Controlling for age and education, a 1-point increase in knowledge score was associated with a 1.6-times increase in the odds of vaccination. There was a monotonic increase in vaccination rates as knowledge score rose (
P
<.001).
CONCLUSION:
The strongly positive correlation between knowledge scores and vaccination emphasizes the vital role that knowledge plays in the decision to be vaccinated for gravida individuals. This elucidates the importance of empowering pregnant persons with reputable and accurate information to increase the likelihood of vaccination in this at-risk population.
Synopsis
The rate of COVID‐19 vaccine uptake in pregnant individuals approximately doubled following the release of a US Practice Advisory recommending COVID‐19 immunization in pregnancy.
The number of gynecologic cancer survivors in the USA is expected to grow to nearly 2 million by 2029. Gynecologic oncologists alone will not be able to care for all of these women. Thus, preparation ...of general obstetrician/gynecologists (OBGYNs) to deliver this care is crucial. Our objective was to assess cancer survivorship training (CST) among OB/GYN residents and to evaluate knowledge in basic gynecologic cancer survivorship. OB/GYN residents were recruited nationally to complete a de novo questionnaire, querying demographics, hours of CST received, teaching methods used, and efficacy of those methods. Survivorship knowledge was assessed by ten questions based on the 2017 Society of Gynecologic Oncology recommendations on post-treatment surveillance, which includes topics appropriate for generalists. Analyses were done using
t
tests and ANOVA, with significance set at
p
= 0.05. In total, 128 residents responded to the survey. Observation was the most common method of CST (53%), with patient contact reported as the most effective method (42.6%). The mean score of correct responses (MSCRs) among all respondents was 61.5%. MSCR significantly improved with increasing post-graduate year (PGY) (
p
= 0.003). Survivorship training method was not associated with improved MSCR. Improvements in MSCR were observed with an increasing number of CST hours (
p
= 0.011). A total of 13.9% of residents reported feeling “very comfortable” with survivorship care, yet 88.5% of respondents indicated they did not want additional CST. More hours of CST are associated with improved resident in knowledge in cancer survivorship care, though deficits still remain. Further investigation into optimizing CST is warranted.
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