ABSTRACT
IntroductionVaccination is critical in controlling the coronavirus disease 19 (COVID-19) pandemic. However, vaccine perception and acceptance among pregnant and lactating women is unknown in Singapore. We aimed to determine the acceptance of COVID-19 vaccination among these two groups of women in Singapore, and factors associated with vaccine acceptance. MethodsWe conducted an anonymous, online survey on the perception and acceptance of the COVID-19 vaccine in pregnant and lactating women at a tertiary hospital in Singapore from 1st March to 31st May 2021. Information on demographics and knowledge were collected, and these factors were assessed for their relationship with vaccine acceptance. ResultsA total of 201 pregnant and 207 lactating women participated. Vaccine acceptance rates in pregnant and lactating women were 30.3% and 16.9% respectively. Pregnant women who were unsure or unwilling to take the vaccine cited concerns about safety of the vaccine during pregnancy (92.9%), while lactating women were concerned about potential long-term negative effects on the breastfeeding child (75.6%). Other factors significantly associated with vaccine acceptance included a lower monthly household income or education level, appropriate knowledge regarding vaccine mechanism and higher perceived maternal risk of COVID-19. Most pregnant (70.0%) and lactating women (83.7%) were willing to take the vaccine only when more safety data during pregnancy and breastfeeding were available. ConclusionsCOVID-19 vaccine acceptance was low among pregnant and lactating women in Singapore. Addressing safety concerns when more data is available and education on mechanism of vaccine action will likely improve acceptance among these women.
ABSTRACT
Tissue engineered grafts lack adequate vascularization and suffer from poor perfusion in vivo curtailing clinical application. Improving vascularization in any tissue implants would hence increase their survivability and treatment efficacy. Many prevascularization strategies established to date involves the angiogenic induction of endothelial progenitor cells in thick tissue engineered scaffolds to obtain vascularization. These 3D scaffolds typically require a dynamic cell culturing system involving/needful of bioreactors to obtain vascularization in thick tissue engineered scaffolds. Herein, we developed a novel method to engineer a vessel network without bioreactor, where 3D blood vessels could be simply obtained in a 2D static cell culturing system. This network could be used to augment the prevascularization of tissue engineered grafts. Endothelial cells (HUVECs) were confluently cultured on resorbable electrospun poly (D, L-lactide-co-glycolide) microfibers of capillary dimensions. These cell encapsulated capillary fibers were further embedded in collagen with HUVECs and vascular endothelial growth factor. Green fluorescent protein and red fluorescent protein expressing HUVECs were used to label cells on fiber and in collagen respectively for visualization and monitoring of capillary network formation. Seeded HUVECs in the hybrid construct were subsequently cultured for 30 days before implantation. Vessel density was measured by the total tubule length per unit area at different time points. In vitro results indicated that the fibers provide contact guidance to form primary networks to direct more vessels branching of HUVECs in hybrid constructs and the vessel integrity of microvasculature was retained after fiber degradation. In addition, these preformed engineered capillaries could capably inosculate with de novo capillaries in collagen when combined, giving rise to a hybrid pre-vascularized scaffold of more extensive vessel network and interconnections, thereby markedly improved prevascularization. When implanted onto the dorsal skin of immune-deficient mice, vessels of hybrid pre-vascularized scaffold also rapidly anastomosed with mice vasculature within a day as confirmed with the immunostaining of endothelial cell markers CD31 and von Willebrand factor. This proof of concept study showed that artificial capillaries formed through contact guidance of endothelial cells on resorbable capillary sized microfibers can significantly enhance prevascularization in tissue engineered constructs intended for surgical implantation.
