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1.
J Interprof Educ Pract ; 29: 100540, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1967226

ABSTRACT

We developed an online interprofessional COVID-19 Vaccine and Pandemic Planning course at the height of the pandemic to prepare health science students for future vaccine delivery. Faculty from nursing, pharmacy, medical, and dentistry developed a six-week online co-curricular interprofessional education activity open to all health science students across seven schools on three campuses within the same University system. Total enrollment included 303, with 228 completing the course from 16 programs. The majority of students were from the Doctorate in Dental Surgery (DDS) program (26.2%) and the Midwestern urban campus (90.3%). Successful rapid course development and implementation was attributed to several factors. The broad range of students across health science programs and differing years in respective programs provides insight to plan future co-curricular activities. The rapid development of a system-wide health science IPE course has implications for continuously changing professional health education needs.

3.
Vaccine ; 2022 Aug 03.
Article in English | MEDLINE | ID: covidwho-1967210

ABSTRACT

X-linked agammaglobulinemia (XLA) is an inborn error of immunity characterized by insufficient production of immunoglobulins and lack of measurable antibody response to vaccines. The rise of novel infections limits the protective effect of immunoglobulin replacement in immunodeficient patients though. While XLA patients are not expected to mount an antibody response to COVID-19 vaccination, it has been demonstrated that XLA patients can mount a T-cell response to COVID-19 vaccines, similar to the influenza vaccine. We present three patients with XLA who received an mRNA COVID-19 vaccine. One patient demonstrated positive antibody response. Many XLA patients do not receive routine vaccinations due to ongoing immunoglobulin replacement therapy and lack of native antibody production, but in addition to T-cell response to vaccination, select XLA patients may mount a positive antibody response. Therefore, COVID-19 vaccination should be encouraged for all XLA patients.

4.
Vaccine ; 2022 Jul 29.
Article in English | MEDLINE | ID: covidwho-1967205

ABSTRACT

BACKGROUND: The safety and immunogenicity of the coadministration of an inactivated SARS-CoV-2 vaccine (Sinopharm BBIBP-CorV), quadrivalent split-virion inactivated influenza vaccine (IIV4), and 23-valent pneumococcal polysaccharide vaccine (PPV23) in adults in China is unknown. METHODS: In this open-label, non-inferiority, randomised controlled trial, participants aged ≥ 18 years were recruited from the community. Individuals were eligible if they had no history of SARS-CoV-2 vaccine or any pneumonia vaccine and had not received an influenza vaccine during the 2020-21 influenza season. Eligible participants were randomly assigned (1:1:1), using block randomization stratified, to either: SARS-CoV-2 vaccine and IIV4 followed by SARS-CoV-2 vaccine and PPV23 (SARS-CoV-2 + IIV4/PPV23 group); two doses of SARS-CoV-2 vaccine (SARS-CoV-2 vaccine group); or IIV4 followed by PPV23 (IIV4/PPV23 group). Vaccines were administered 28 days apart, with blood samples taken on day 0 and day 28 before vaccination, and on day 56. RESULTS: Between March 10 and March 15, 2021, 1152 participants were recruited and randomly assigned to three groups (384 per group). 1132 participants were included in the per-protocol population (375 in the SARS-CoV-2 + IIV4/PPV23 group, 380 in the SARS-CoV-2 vaccine group, and 377 in the IIV4/PPV23 group). The seroconversion rate (100 % vs 100 %) and GMT (159.13 vs 173.20; GMT ratio of 0.92 [95 % CI 0.83 to 1.02]) of SARS-CoV-2 neutralising antibodies in the SARS-CoV-2 + IIV4/PPV23 group was not inferior to those in the SARS-CoV-2 vaccine group. The SARS-CoV-2 + IIV4/PPV23 group was not inferior to the IIV4/PPV23 group in terms of seroconversion rates and GMT of influenza virus antibodies for all strains except for the seroconversion rate for the B/Yamagata strain. The SARS-CoV-2 + IIV4/PPV23 group was not inferior to the IIV4/PPV23 group regarding seroconversion rates and GMC of Streptococcus pneumoniae IgG antibodies specific to all serotypes. All vaccines were well tolerated. CONCLUSIONS: The coadministration of the inactivated SARS-CoV-2 vaccine and IIV4/PPV23 is safe with satisfactory immunogenicity. This study is registered with ClinicalTrials.gov, NCT04790851.

5.
Public Health Pract (Oxf) ; 4: 100303, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1967024

ABSTRACT

Objective: This study aimed to investigate the breakthrough infection rate and safety profile of the AstraZeneca vaccine. Methods: The breakthrough COVID-19 infection rate was defined as a positive polymerase chain reaction test 14 days after the vaccine dose. Safety was assessed as local reactions and systemic events that occurred within 14 days of receiving vaccine doses. Results: The average age of the 265 participants was 43.85 years and 169 (63.77%) were male. . After the second dose, 18 (6.71%) participants contracted the infection. The SARS-CoV-2 delta variant was responsible for all infections but no participants required hospitalisation. We found significant correlations between post-vaccination IgG levels and post-vaccination infection (P = 0.001; odds ratio [OR] = 0.959; 95% Confidence interval [CI]: 0.944-0.974), and between a history of previous infection and post-vaccination infection rates (P = 0.005; OR = 0.1; 95%CI:0.009-0.6). IgG levels were significantly higher in women than in men (P = 0.006) and in patients who developed side effects after vaccination than in those without side effects (P = 0.04). A significant association was found between a history of COVID-19 infection prior to vaccination and IgG levels (P = 0.001). Conclusions: The vaccine is effective in preventing severe disease, with few side effects.

6.
Omega ; 113: 102725, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1966969

ABSTRACT

This paper develops an approach to optimize a vaccine distribution network design through a mixed-integer nonlinear programming model with two objectives: minimizing the total expected number of deaths among the population and minimizing the total distribution cost of the vaccination campaign. Additionally, we assume that a set of input parameters (e.g., death rate, social contacts, vaccine supply, etc.) is uncertain, and the distribution network is exposed to disruptions. We then investigate the resilience of the distribution network through a scenario-based robust-stochastic optimization approach. The proposed model is linearized and finally validated through a real case study of the COVID-19 vaccination campaign in France. We show that the current vaccination strategies are not optimal, and vaccination prioritization among the population and the equity of vaccine distribution depend on other factors than those conceived by health policymakers. Furthermore, we demonstrate that a vaccination strategy mixing the population prioritization and the quarantine restrictions leads to an 8.5% decrease in the total number of deaths.

7.
Microb Pathog ; : 105687, 2022 Jul 30.
Article in English | MEDLINE | ID: covidwho-1966949

ABSTRACT

BACKGROUND: and Introduction: SARS-CoV-2 is currently considered as the most challenging issue in the field of health and medicine by causing a global pandemic. Vaccines are counted as a promising candidate to terminate this deadly pandemic. Various structural proteins in SARS-CoV-2 have recently drawn attention to be utilized as candidate vaccines to stimulate immune responses against COVID-19. MATERIALS AND METHODS: In current study, the RBD protein was cloned and expressed in E. coli host. Then, the expressed RBD protein was purified and its characterizations were evaluated through various methods. Gold nanoparticles, which were utilized as a carrier for candidate Nano-vaccine, were synthesized via oxidation-reduction reaction. While Gold NPs-conjugated RBD was injected into the second treatment group, in the first candidate vaccine, RBD was injected into the first treatment group solely. Complete and Incomplete Freud's Adjuvant were also utilized for both treatment groups to enhance the immune responses against RBD antigen. Immunizations were repeated 2 times in 14-day intervals to boost the immune system of BALB/c mice. The humoral and cell-mediated immune responses were examined through immune and cytokine assays. RESULTS: Our outcomes demonstrate that strong short-term humoral immunity (IgM) was induced in both the first and second treatment group, while long-term humoral responses (IgG) were only observed in the second treatment group. While stronger short- and long-term humoral (IgM and IgG, respectively) were observed in the second treatment group, particular cytokines production (TNF-ɑ and IFN-γ) as a marker of cell-mediated responses were significantly higher in the first treatment group. DISCUSSION AND CONCLUSION: Our study results show the high potentiality of RBD protein as an appropriate stimulating antigen in vaccine synthesis and testifies RBD-based candidate vaccines to control the COVID-19 pandemic. Our outcomes also recommend that Nano-vaccines can be more suitable candidates when stronger long-term immune responses matter.

8.
Vaccine X ; : 100202, 2022 Aug 03.
Article in English | MEDLINE | ID: covidwho-1966901

ABSTRACT

Encouraging protection results from current mRNA-based SARS-CoV-2 vaccine platforms are primarily due to the induction of SARS- CoV-2- specific B cell antibody and CD4+ T cell. Even though, current mRNA vaccine platforms are adept in inducing SARS-CoV2-specific CD8+ T cell, much less is known about CD8 T cells contribution to the overall vaccine protection. Our allogeneic cellular vaccine, based on a secreted form of the heat-shock protein gp96-Ig, achieves high frequencies of polyclonal CD8+ T cell responses to tumor and infectious antigens through antigen cross-priming in vivo. We and others have shown that gp96-Ig, in addition to antigen-specific CD8+ T cell anti-tumor and anti-pathogen immunity, primes antibody responses as well. Here, we generated a cell-based vaccine that expresses SARS-Cov-2 Spike (S) protein and simultaneously secretes gp96-Ig and OX40L-Fc fusion proteins. We show that co-secretion of gp96-Ig-S peptide complexes and the OX40L-Fc costimulatory fusion protein in allogeneic cell lines results in enhanced activation of S protein-specific IgG antibody responses. These findings were further strengthened by the observation that this vaccine platform induces T follicular helper cells (TFH) and protein-S -specific CD8+ T cells. Thus, a cell-based gp96-Ig vaccine/OX40-L fusion protein regimen provides encouraging translational data that this vaccine platform induces pathogen-specific CD8+, CD4+ T and B cell responses, and may cohesively work as a booster for FDA-approved vaccines. Our vaccine platform can be rapidly engineered and customized based on other current and future pathogen sequences.

9.
Int J Surg ; : 106806, 2022 Aug 01.
Article in English | MEDLINE | ID: covidwho-1966637
10.
Gynecol Obstet Fertil Senol ; 2022 Jul 29.
Article in French | MEDLINE | ID: covidwho-1966582

ABSTRACT

OBJECTIVE: SARS-CoV-2 is more likely to cause severe cases in pregnant women. They were part of the priority groups since April 2021 to benefit from SARS-CoV-2 vaccination before its extent to general population. This contribution aims to evaluate, in the postpartum period, the achievement of COVID-19 vaccination and factors associated in women during their pregnancy. Material & method Multicenter cross-sectional survey study conducted from September to December 2021 with online self-questionnaire. All postpartum patients hospitalized in one of the 6 participating maternity hospitals were invited to answer. The questionnaire asked patients about their demographic characteristics, vaccination modalities, vaccine tolerance, and their general perception of vaccination. Results Of the 371 women who responded, the vaccination rate was 65.7% (IC95% [60,8-70,4]), whom 98.8% entirely during pregnancy. Associated factors with vaccination during pregnancy were older age, higher socio-professional category, and prior information provided by health professionals. Factors that appear to motivate vaccination were personal protection and protection of the newborn. Finally, main factors negatively influencing the vaccination process were the fear of vaccine side effects and the negative perception of vaccines in general. Discussion Acceptability and information about the vaccine by health professionals is in constant improvement. Information campaigns should be continued to improve the acceptability of vaccination, in light of the accumulating data.

11.
EBioMedicine ; : 104203, 2022 Jul 29.
Article in English | MEDLINE | ID: covidwho-1966508

ABSTRACT

BACKGROUND: To investigate a vaccine technology with potential to protect against coronavirus disease 2019 (COVID-19) and reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with a single vaccine dose, we developed a SARS-CoV-2 candidate vaccine using the live vesicular stomatitis virus (VSV) chimeric virus approach previously used to develop a licensed Ebola virus vaccine. METHODS: We generated a replication-competent chimeric VSV-SARS-CoV-2 vaccine candidate by replacing the VSV glycoprotein (G) gene with coding sequence for the SARS-CoV-2 Spike glycoprotein (S). Immunogenicity of the lead vaccine candidate (VSV∆G-SARS-CoV-2) was evaluated in cotton rats and golden Syrian hamsters, and protection from SARS-CoV-2 infection also was assessed in hamsters. FINDINGS: VSV∆G-SARS-CoV-2 delivered with a single intramuscular (IM) injection was immunogenic in cotton rats and hamsters and protected hamsters from weight loss following SARS-CoV-2 challenge. When mucosal vaccination was evaluated, cotton rats did not respond to the vaccine, whereas mucosal administration of VSV∆G-SARS-CoV-2 was found to be more immunogenic than IM injection in hamsters and induced immunity that significantly reduced SARS-CoV-2 challenge virus loads in both lung and nasal tissues. INTERPRETATION: VSV∆G-SARS-CoV-2 delivered by IM injection or mucosal administration was immunogenic in golden Syrian hamsters, and both vaccination methods effectively protected the lung from SARS-CoV-2 infection. Hamsters vaccinated by mucosal application of VSV∆G-SARS-CoV-2 also developed immunity that controlled SARS-CoV-2 replication in nasal tissue. FUNDING: The study was funded by Merck Sharp & Dohme, Corp., a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and The International AIDS Vaccine Initiative, Inc. (IAVI), New York, USA. Parts of this research was supported by the Biomedical Advanced Research and Development Authority (BARDA) and the Defense Threat Reduction Agency (DTRA) of the US Department of Defense.

12.
EBioMedicine ; 83: 104196, 2022 Aug 03.
Article in English | MEDLINE | ID: covidwho-1966507

ABSTRACT

BACKGROUND: In late 2021, the SARS-CoV-2 Omicron (B.1.1.529) variant of concern (VoC) was reported with many mutations in the viral spike protein that were predicted to enhance transmissibility and allow viral escape of neutralizing antibodies. Within weeks of the first report of B.1.1.529, this VoC has rapidly spread throughout the world, replacing previously circulating strains of SARS-CoV-2 and leading to a resurgence in COVID-19 cases even in populations with high levels of vaccine- and infection-induced immunity. Studies have shown that B.1.1.529 is less sensitive to protective antibody conferred by previous infections and vaccines developed against earlier lineages of SARS-CoV-2. The ability of B.1.1.529 to spread even among vaccinated populations has led to a global public health demand for updated vaccines that can confer protection against B.1.1.529. METHODS: We rapidly developed a replicating RNA vaccine expressing the B.1.1.529 spike and evaluated immunogenicity in mice and hamsters. We also challenged hamsters with B.1.1.529 and evaluated whether vaccination could protect against viral shedding and replication within respiratory tissue. FINDINGS: We found that mice previously immunized with A.1-specific vaccines failed to elevate neutralizing antibody titers against B.1.1.529 following B.1.1.529-targeted boosting, suggesting pre-existing immunity may impact the efficacy of B.1.1.529-targeted boosters. Furthermore, we found that our B.1.1.529-targeted vaccine provides superior protection compared to the ancestral A.1-targeted vaccine in hamsters challenged with the B.1.1.529 VoC after a single dose of each vaccine. INTERPRETATION: Our data suggest that B.1.1.529-targeted vaccines may provide superior protection against B.1.1.529 but pre-existing immunity and timing of boosting may need to be considered for optimum protection. FUNDING: This research was supported in part by the Intramural Research Program, NIAID/NIH, Washington Research Foundation and by grants 27220140006C (JHE), AI100625, AI151698, and AI145296 (MG).

13.
Data Brief ; : 108503, 2022 Aug 02.
Article in English | MEDLINE | ID: covidwho-1966490

ABSTRACT

Vaccine hesitancy is considered as one main cause of the stagnant uptake ratio of COVID-19 vaccines in Europe and the US where vaccines are sufficiently supplied. A fast and accurate grasp of public attitudes toward vaccination is critical to addressing vaccine hesitancy, and social media platforms have proved to be an effective source of public opinions. In this paper, we describe the collection and release of a dataset of tweets related to COVID-19 vaccines. This dataset consists of the IDs of 2,198,090 tweets collected from Western Europe, 17,934 of which are annotated with the originators' vaccination stances. Our annotation will facilitate using and developing data-driven models to extract vaccination attitudes from social media posts and thus further confirm the power of social media in public health surveillance. To lay the groundwork for future research, we not only perform statistical analysis and visualization of our dataset, but also evaluate and compare the performance of established text-based benchmarks in vaccination stance extraction. We demonstrate one potential use of our data in practice in tracking the temporal changes in public COVID-19 vaccination attitudes.

14.
Clin Microbiol Infect ; 2022 Aug 02.
Article in English | MEDLINE | ID: covidwho-1966444

ABSTRACT

OBJECTIVES: To describe effectiveness of mRNA vaccines by comparing 2-dose (2D) and 3-dose (3D) healthcare worker (HCW) recipients in the setting of Omicron variant dominance. Performance of 2D and 3D vaccine series against SARS-CoV-2 variants and the clinical outcomes of HCWs may inform return-to-work guidance. METHODS: In a retrospective study from December 15, 2020 - January 15, 2022, SARS CoV-2 infections among HCWs at a large tertiary cancer center in New York City (NYC) were examined to estimate infection rates over the omicron period (aggregated positive tests/person-days) and 95% CIs in 2D and 3D mRNA vaccinated HCWs and were compared using rate ratios. We describe the clinical features of post-vaccine infections and impact of prior (pre-Omicron) COVID infection on vaccine effectiveness (VE). RESULTS: Among the 20,857 HCWs in our cohort, 20,660 completed the 2D series with an mRNA vaccine during our study period and 12,461 had received a third dose by January 15, 2022. The infection rate ratio for 2D vs. 3D vaccinated HCWs was 0.667 (95% CI 0.623, 0.713) for an estimated 3D VE of 33.2% compared to 2 doses only during the Omicron dominant period from 12/15/21- 1/15/22. Breakthrough (BT) Omicron infections after 3D + 14 days occurred in 1315 HCWs. Omicron infections were mild, with 16% of 3D and 11% 2D HCWs being asymptomatic. CONCLUSIONS: Study demonstrates improved vaccine-derived protection against COVID-19 infection in 3D vs. 2D mRNA vaccinees during the Omicron surge. The advantage of 3D vaccination was maintained irrespective of prior COVID-19 infection status.

15.
Clin Imaging ; 90: 78-89, 2022 Jul 29.
Article in English | MEDLINE | ID: covidwho-1966437

ABSTRACT

Cardiovascular involvement is a common complication of COVID-19 infection and is associated to increased risk of unfavorable outcome. Advanced imaging modalities (coronary CT angiography and Cardiac Magnetic Resonance) play a crucial role in the diagnosis, follow-up and risk stratification of patients affected by COVID-19 pneumonia with suspected cardiovascular involvement. In the present manuscript we firstly review current knowledge on the mechanisms by which SARS-CoV-2 can trigger endothelial and myocardial damage. Secondly, the implications of the cardiovascular damage on patient's prognosis are presented. Finally, we provide an overview of the main findings at advanced cardiac imaging characterizing COVID-19 in the acute setting, in the post-acute syndrome, and after vaccination, emphasizing the potentiality of CT and CMR, the indication and their clinical implications.

16.
Clin Epidemiol Glob Health ; 17: 101113, 2022.
Article in English | MEDLINE | ID: covidwho-1966421

ABSTRACT

Background: Vaccine hesitancy is of considerable concern as it threatens the great potential of a vaccine against COVID-19. This study aims to determine factors associated with community health workers' willingness to participate in clinical trials of COVID-19 vaccine, and their vaccination intention, in India. Methods: A cross-sectional study was conducted among 377 community health workers using self-administered anonymous questionnaire during the lockdown periods in India. Participant's socio-demographics, willingness-to-participate in COVID-19 vaccine trials, intention to accept COVID-19 vaccine were recorded in a Likert scale. Data were analysed descriptively, and a multivariate logistic regression model was used to investigate factors associated with willingness to participate and accept the vaccine. Results: Among 377 CHWs, 70 (19%) intended to participate in COVID-19 vaccine trial, 151 (40%) responded positively regarding their intention to get vaccinated. Those with knowledge on development of COVID-19 vaccine [aOR 3.05 (95% CI: 1.18-7.88), p = 0.021], and men [aOR 3.69 (95% CI: 1.51-8.97), p = 0.004] were more willing to participate in clinical-trial, while an undergraduate degree, and trust in domestic vaccines were identified as deterrents for the same. Perceiving COVID-19 as risk [aOR 2.31 (95% CI: 1.24-4.31), p = 0.009], and male gender [aOR 2.39 (95% CI: 1.17-4.88), p = 0.017] were factors associated with intention to get vaccinated. Respondents who had knowledge about COVID-19 virus were less likely to uptake the hypothetical vaccine [aOR 0.32 (95% CI: 0.12-0.88), p = 0.027]. Conclusions: Increasing knowledge regarding COVID-19 is not enough to improve vaccine acceptance rates. Targeted interventions addressing socio-demographic determinants related to COVID-19 vaccination should help improve acceptance.

17.
Ann Med Surg (Lond) ; 80: 104299, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1966316

ABSTRACT

The COVID-19 pandemic is a public health emergency on a global scale, and vaccination has been shown to be effective in containing the pandemic. Social issues surrounding COVID-19 vaccination contribute to the level of skepticism and opposition expressed by a sizable proportion of the global population. The need to address socio-cultural and religious standpoints on COVID-19 immunization and related discussions is becoming more pressing as the pandemic's socioeconomic implications become more concerning. Without a doubt, failing to address social issues jeopardizes countries' ability to achieve the WHO-recommended 70 percent coverage target for all countries, which would halt the pandemic by creating a global herd immunity. In this article, we discussed some of these social issues as well as emerging strategies for addressing these challenges and driving a rapid increase in COVID-19 vaccine uptake.

18.
Ann Med Surg (Lond) ; 80: 104282, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1966315

ABSTRACT

Systemic lupus erythematosus (SLE) is an autoimmune disease that can cause both direct and indirect inflammatory damage to multiple organs. Clinical symptoms in the skin, joints, kidneys, and central nervous system, as well as serological indicators such as antinuclear antibodies (ANA), notable antibodies to dsDNA, are used to diagnose SLE. mRNA SARS-CoV-2 vaccines have been shown to trigger SLE flares and the development of new rheumatic diseases. SARS-CoV-2 mRNA vaccinations increase type I interferon (INF), which is not only known to have a role in the antiviral response but is also a crucial cytokine in the pathophysiology of SLE. Furthermore, both the mRNA and adenovirus vaccines boost the production of type 1 interferons, which are required for the spread of SARS-CoV-2. The danger of not administering the COVID-19 vaccination to SLE patients is significantly larger than the likelihood of its adverse effects, which are most likely caused by intrinsic immune failure, demographic disease activity, medications, linked organ damage, and comorbidities. The adverse effects of COVID-19 vaccination in SLE patients are common (about 50%), although they do not interfere with daily functioning in the majority of cases. Several precautions can be taken to avoid the complications associated with COVID-19 vaccinations.

19.
Am J Obstet Gynecol MFM ; : 100704, 2022 Aug 02.
Article in English | MEDLINE | ID: covidwho-1966286

ABSTRACT

BACKGROUND: Clinical trials of the mRNA COVID-19 vaccines excluded individuals with active reproductive needs (attempting to conceive, currently pregnant, and/or lactating). Women comprise three-quarters of healthcare workers in the United States, an occupational field among the first to receive the vaccine. Professional medical and government organizations encouraged shared decision-making and access to vaccination among those with active reproductive needs. OBJECTIVE: To characterize information sources used by pregnancy-capable healthcare workers for information about the COVID-19 vaccines, and to compare the self-reported "most important" source by respondents' active reproductive needs, if any. STUDY DESIGN: This was a web-based national survey of female, US-based healthcare workers in January 2021. Recruitment was conducted using social media and subsequent sharing via word of mouth. We classified respondents into six groups based on self-reported reproductive needs: 1) preventing pregnancy, 2) attempting pregnancy, 3) currently pregnant, 4) lactating, 5) attempting pregnancy and lactating, and 6) currently pregnant and lactating. We provided respondents with a list of information sources (friends, family, OB-GYN, pediatrician, news, social media, government organizations, their employer, and "other") and asked respondents which source(s) they used when looking for information about the vaccine, and their most important source. We used descriptive statistics to characterize the information sources and compared the endorsement of government organizations and OB-GYN as the most important information source between reproductive groups using chi-square. Effect size was calculated using Cramer's V. RESULTS: Our survey had 11,405 unique respondents: 5,846 (51.3%) were preventing pregnancy, 955 (8.4%) were attempting pregnancy, 2,196 (19.3%) were currently pregnant, 2,250 (19.7%) were lactating, 67 (0.6%) were attempting pregnancy and lactating, and 91 (0.8%) were currently pregnant and lactating. The most endorsed information sources were government organizations (88.7%), employers (48.5%), OB-GYN (44.9%), and social media (39.6%). For the most important information source, the distribution of respondents endorsing government organizations was different between reproductive groups (p<0.001), most common among respondents preventing pregnancy (62.6%) and least common among those currently pregnant (31.5%). We observed an inverse pattern among respondents endorsing an OB-GYN as the most important source: the source was most common among currently pregnant respondents (51.4%) and least common among those preventing pregnancy (5.8%), p<0.001. The difference in endorsement of social media as an information source between groups was significant but had a small effect size. CONCLUSIONS: Healthcare workers use government and professional medical organizations for information. Respondents attempting pregnancy, pregnant, and/or lactating are more likely to use social media and an OB-GYN as information sources for vaccine decision-making. This data can inform public health messaging and counseling for clinicians.

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