ABSTRACT
Background: The Government of India recommends pregnant and lactating women to get vaccinated against the Novel Coronavirus Disease 2019 (COVID-19). However, vaccine hesitancy in this population adversely affects the uptake of vaccination. There is an urgent need for assessing extent of vaccine hesitancy in this group and study its determinants, motivation stages and barriers. Objective(s): To determine psychosocial Factors affecting uptake of COVID-19 Vaccination in lactating women and their attitude towards infant vaccination in general and stage of motivation for vaccination. Method(s): A cross-sectional analysis survey was conducted amongst 80 women visiting postnatal OPD or immunization clinic of a tertiary care hospital of Delhi using Oxford COVID-19 vaccine hesitancy scale (OC19-VHS) and participants were classified as hesitant, non-hesitant, and unsure. Result(s): We enrolled 80 postnatal women with mean age of 25.3 ((SD, 9.6) years. The vaccine hesitancy rate was 44% acceptance rate in the participants. Regression analysis showed young age group (20-45 years), low socioeconomic status and no past history of COVID infection were factors independently associated with Vaccine hesitancy. Doubts on vaccine safety and concerns about its impact on lactation were primary barriers affecting vaccine uptake. Amongst participants in vaccine hesitancy group only 40% had got their children completely vaccinated for age. Conclusion(s): Nearly 40% lactating women visiting hospital had vaccine hesitancy and concern for its impact on lactation and vaccine safety were the primary determinants for reduced vaccine uptake in lactating women.
ABSTRACT
Background: The planet has been hit by the novel coronavirus since December 2019, which has not only affected the day-to-day activities but has also affected the health-seeking approach of the general population. The reports from the National Institute on Drug Abuse survey hint toward a rise in opioid use in the states. Even in India, the utilization of health services, especially the outpatient department (OPD) and opioid substitution clinics have been affected due to the impact of COVID-19 and subsequent national and regional lockdowns. The Indian studies reflect upon the experience and measures to continue the treatment facilities in substance users, yet none are available to reflect upon the impact of COVID-19 on the pattern of opioid use or functionality of OPD services. Objective: The objective of this study is to study the impact of COVID-19 pandemic on treatment seeking among opioid users from OPD-based opioid treatment centers: a retrospective study. Methodology: A retrospective study was done in an OPD-based opioid treatment center of a tertiary care hospital to analyze the impact of COVID-19 on treatment-seeking opioid users by comparing the data of pre-COVID-19 (April 2019-March 2020) and during COVID-19 (April 2020-March 2021) OPD visits by opioid users. The OPD visits data were collected, including the number of visits, the total number of buprenorphine tablets dispensed, and the dose of buprenorphine consumed per month. The data collected were further analyzed for the descriptive and analytic statistics using the SPSS software version 23.0. Results: During the pre-COVID-19 (April 2019-March 2020) duration, there were a total of 1104 (average 92/month) OPD visits and 4818 (Average 401/month) buprenorphine tablets were dispensed;whereas during the COVID-19 year (April 2020-March 2021), it was 980 (average 81.66/month) visits and 5174 (431/month) tablets. The results were further compared using the paired t-test, which was found to be statistically significant for the number of tablets dispensed, whereas not statistically significant for the number of OPD visits and doses. Conclusion: Although the COVID-19 pandemic has affected the feasibility to seek treatment in opioid users, it has not significantly affected OPD visits for opioid treatment at our center. Although the policy changes such as Indian Psychiatry Society (IPS) interim guidelines for opioid substitution therapy have been beneficial to facilitate the harm reduction and treatment-seeking attitude and have not affected the treatment seeking as expected due to lockdown and transportation which have been a hurdle. Further regulations on opioid treatment OPD, Tele-consultation services and mobile mental health services may be helpful to ensure continuity of treatment and harm reduction among the opioid users.