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TITLE: Vaccine and booster acceptance in women considering or undergoing fertility treatments during the omicron surge of the COVID-19 pandemic. Objective(s): To evaluate perceptions of COVID-19 vaccination and vaccine booster during the omicron surge in women considering or undergoing fertility treatment. Material(s) and Method(s): IRB approval was obtained. Cross-sectional anonymous surveys of patients were collected from a single academic fertility center. Participants were randomized 1:1 to receive a one-page graphic of supplemental education, which provided basic facts regarding the association between infertility and COVID-19 vaccination and boosters based on the ASRM COVID-19 taskforce recommendations. Beliefs related to COVID-19 vaccination and boosters were assessed with dichotomous, Likert scale and multiple-choice questions. Assessment of trust in the medical system was conducted via the Medical Mistrust Index (MMI). Descriptive data and chi-square analysis were used to compare the intervention v. no intervention groups. Result(s): To date, a total of 422/2558 surveys have been received, response rate = 16.5%. The participants were 36.40 years old (SD=4.28), married (89.3%), nulliparous (63.3%), White (82.5%), Asian (5.9%), Hispanic (4.0%), and Black (3.3%) and 47.7% had a history of at least one pregnancy loss. Among the participants who reported their vaccination status (n=408), 96.8% of the study population were fully vaccinated, 86.3% had received their booster dose, 4.5% were fully vaccinated but did not plan on receiving a booster, while only 2.4% did not plan on getting vaccinated. Of those able to be vaccinated during pregnancy, 23.5% were vaccinated during pregnancy. Patients with vaccine hesitancy had higher medical mistrust scores (r=.21, p<.001). Participants with higher MMI scores had higher PHQ-8 scores (p<.001) and GAD-7 scores (p<0.001), were more likely to have a loved one diagnosed with COVID-19 (p=.002), were less likely to have lost their job due to the COVID-19 pandemic (p=.001) and reported concerns about vaccine side effects on miscarriage (p=0.006). Participants who received the educational material were more likely to know that pregnant women with COVID-19 had an increased risk of death, stillbirth and preterm birth (p=.017). Conclusion(s): Two years after the onset of the COVID-19 pandemic, the majority of women in this study were vaccinated and had already received their booster dose. Participants with the greatest medical mistrust expressed concerns about COVID-19 vaccination and risk of miscarriages. The intervention increased patients' knowledge regarding maternal and fetal risks associated with COVID-19 infection. Impact Statement: Though the vaccination rate was significantly higher among the survey participants compared to the national vaccination rate, vaccine hesitancy was higher in patients with increased level of medical mistrust. Educational handout appears to be a reliable strategy to correctly inform patients on the risks associated with COVID-19 and pregnancy though they did not change vaccine hesitancy. Copyright © 2022
ABSTRACT
OBJECTIVE: To evaluate perceptions of COVID-19 vaccination in women considering or undergoing fertility treatment. MATERIALS AND METHODS: IRB approval was obtained. Crosssectional anonymous surveys of patients were collected from a single academic fertility center. Participants were randomized 1:1 to receive a onepage graphic of supplemental education providing basic facts and benefits regarding COVID-19 vaccination based on the ASRM COVID-19 taskforce recommendations. Beliefs related to COVID-19 vaccination was assessed with dichotomous, Likert scale and multiple-choice questions. Assessment of trust in the medical system was conducted via the Medical Mistrust Index (MMI). Descriptive data and chi-square analysis were used to compare responses between the intervention v. no intervention groups. RESULTS: To date, 1130/3595 surveys have been received, response rate = 31.4%. Except for age (35.87, SD=4.0 vs 35.68, SD=4.187 p<.05), both the intervention and non-intervention groups were similar in term of demographics, including education and race;participants were predominantly white (77.8%), married (89.2%), and nulliparous (68.6%). 30.3% reported that a loved one or themselves (7.5%) tested positive for COVID-19, 46.7% knew someone who had been hospitalized or who died of COVID-19, and 6.8% stated they would not get the vaccine. Most participants (54.8%) strongly disagreed or disagreed that the vaccine could affect future fertility. Among the participants who reported their vaccination status (N=790), 25.3% of the study population received one dose, 61.4% completed vaccination while 11% did not plan on getting vaccinated. Compared to those who intended to receive the vaccine, 97.9% v. 70.4% believed that the COVID-19 vaccine given during pregnancy does not cause genetic abnormalities in a fetus or infertility (98.8% v. 81.5%), that a more severe infection has been associated with pregnancy (81.3% v. 74.6%) and strongly disagreed (32.7% v. 1.7%) or disagreed (29.0% v. 1.7%) on having concerns on its impact on future pregnancies (p<.05). Similar patterns were seen with those with higher scores on the MMI and beliefs that the vaccines can cause harm. Participants in the intervention group were more likely to believe that COVID-19 vaccination does not cause genetic abnormalities in a fetus (98.0% v. 94.2%), does not cause infertility (99% v. 96.2%) and that a more severe infection has been associated with pregnancy (81.3% v. 74.6%) (all p <.05). Higher scores on the MMI but not the intervention was associated with vaccine hesitancy (p=.01). CONCLUSIONS: The majority of women in this study had received or planned to receive the COVID-19 vaccine. Participants with greater trust in the medical system were more likely to receive the vaccine. The intervention increased patient's knowledge regarding the vaccine and most patients did not believe that COVID-19 vaccination negatively impacts infertility. IMPACT STATEMENT: Vaccine hesitancy was associated with mistrust of the medical system. Efforts should be made to improve trust and thereby increase willingness to participate in recommended medical interventions.
ABSTRACT
OBJECTIVE: To evaluate psychological distress during the COVID-19 pandemic and any associations with vaccination beliefs in women considering or undergoing fertility treatment. MATERIALS AND METHODS: IRB approval was obtained. Crosssectional anonymous surveys of patients were collected from a single academic fertility center. Assessment of trust in the medical system was conducted via the Medical Mistrust Index (MMI) and mental health was evaluated via the Patient Health Questionnaire Depression Scale (PHQ-8) and the Generalized Anxiety Disorder-7 (GAD-7). Attitudes regarding COVID vaccination was collected. Descriptive data and chi-square analysis with pairwise Bonferroni adjusted Z-tests and ANOVA was used to examine the MMI, GAD-7, and PHQ-8. RESULTS: To date, a total of 1130/3595 surveys have been received, response rate = 31.4%. The participants were 35.82 years old (SD=4.102), married (89.2%), nulliparous (69.3%), White (77.8%) Asian (9.3%), Hispanic (4.4%) Black (4.4%), 28.1% reported > 1 year of infertility and 31.5% > 2 years of infertility. 50.3% were currently receiving or had received psychotherapy in the past, 36.2% reported a history of medication use for mood, depression or anxiety. Among the participants, 23.1% reported initiating psychotherapy and/or medical treatment for mood, depression and/or anxiety after March 2020. Mild (32.9%), moderate (49.4%), moderately severe (14.1%) and severe (3.6%) symptoms of depression were reported on the PHQ-8. Similar levels of distress were seen on the GAD-7 scale, with mild (47.0%), moderate (39.1%) and severe (13.9%) anxiety symptoms reported. Both the PHQ-8 and GAD-7 indicate that participants have been in distress since the beginning of the pandemic. Participants with the highest MMI scores had higher GAD-7 scores (p=0.01), reported more concerns about vaccine side effects on fertility and/or ability to get pregnant and believed that the vaccine can cause abnormalities in a fetus or one's body (p<0.05). GAD-7 and PHQ-8 scores were not associated with vaccine hesitancy. CONCLUSIONS: Clinically significant levels of anxiety and depression were found in the majority of participants. Although many participants reported receiving psychological treatment prior to the pandemic, almost a quarter of women reported initiation of mental health treatments after the onset of the pandemic. Although psychological distress was not related to vaccine hesitancy, those with higher levels of anxiety reported greater mistrust in the medical system. IMPACT STATEMENT: There are high rates of anxiety and depression amongst women currently considering or undergoing fertility treatments with almost 25% of participants initiating mental health treatment after the onset of the COVID-19 pandemic. Higher mistrust in the healthcare system was associated with increased anxiety symptoms. This suggests an even greater current need to offer psychological support to this group of patients.
ABSTRACT
Autonomous systems have played an important role in response to the Covid-19 pandemic. Notably, there have been multiple attempts to leverage Unmanned Aerial Vehicles (UAVs) to disinfect surfaces. Although recent research suggests that surface transmission is less significant than airborne transmission in the spread of Covid-19, surfaces and fomites can play, and have played, critical roles in the transmission of Covid-19 and many other viruses, especially in settings such as child daycares, schools, offices, and hospitals. Employing UAVs for mass spray disinfection offers several potential advantages, including high-throughput application of disinfectant, large scale deployment, and the minimization of health risks to sanitation workers. Despite these potential benefits and preliminary usage of UAVs for disinfection, there has been little research into their design and effectiveness. In this work, we present an autonomous UAV capable of effectively disinfecting indoor surfaces. We identify relevant parameters such as disinfectant type and concentration, and application time and distance required of the UAV to disinfect high-touch surfaces such as door handles. Finally, we develop a robotic system that enables the fully autonomous disinfection of door handles in an unstructured and previously unknown environment. To our knowledge, this is the smallest untethered UAV ever built with both full autonomy and spraying capabilities, allowing it to operate in confined indoor settings, and the first autonomous UAV to specifically target high-touch surfaces on an individual basis with spray disinfectant, resulting in more efficient use of disinfectant.
ABSTRACT
Public goods are often either over-consumed in the absence of regulatory mechanisms, or remain completely unused, as in the Covid-19 pandemic, where social distance constraints are enforced to limit the number of people who can share public spaces. In this work, we plug this gap through market mechanisms designed to efficiently allocate capacity constrained public goods. To design these mechanisms, we leverage the theory of Fisher markets, wherein each agent is endowed with an artificial currency budget that they can spend to avail public goods. While Fisher markets provide a strong methodological backbone to model resource allocation problems, their applicability is limited to settings involving two types of constraints - budgets of individual buyers and capacities of goods. Thus, we introduce a modified Fisher market, where each individual may have additional physical constraints, characterize its solution properties and establish the existence of a market equilibrium. Furthermore, to account for additional constraints we introduce a social convex optimization problem where we perturb the budgets of agents such that the KKT conditions of the perturbed social problem establishes equilibrium prices. Finally, to compute the budget perturbations we present a fixed point scheme and illustrate convergence guarantees through numerical experiments. Thus, our mechanism, both theoretically and computationally, overcomes a fundamental limitation of classical Fisher markets, which only consider capacity and budget constraints. © 2020, Springer Nature Switzerland AG.