COVID-19 Vaccine Acceptance in Pregnant Women in the United States: A Systematic Review and Meta-Analysis.

Purpose: Pregnant women are vulnerable to Coronavirus Disease 2019 (COVID-19) complications, yet may hesitate to get vaccinated. It is important to identify racial/ethnic and other individual characteristics associated with COVID-19 vaccine acceptance in the United States during pregnancy. Methods: We searched PubMed, Embase, and Web of Science for articles published through January 2023 for keywords/terms related to immunization, COVID-19, and pregnancy, and performed a systematic review and meta-analysis to examine characteristics associated with vaccine acceptance. Results: Of 1,592 articles, 23 met inclusion criteria (focused on pregnant women in the United States, and their willingness or hesitation to vaccinate). Twenty-two of the studies examined receipt of ≥1 COVID-19 vaccine dose and/or intention to vaccinate, while one examined vaccine hesitancy. Vaccine acceptance rates ranged from 7% to 78.3%. Meta-analyses demonstrated that compared with Whites, Hispanics (odds ratios [OR] 0.72; 95% confidence interval [CI] 0.58-0.91) and Blacks (OR 0.44; 95% CI 0.30-0.63) had less COVID-19 vaccine acceptance, while Asians (OR 1.78; 95% CI 1.10-2.88) had greater vaccine acceptance. College graduation or more (OR 3.25; 95% CI 2.53-4.17), receipt or intention to receive the influenza vaccine (OR 3.46; 95% CI 2.22-5.41), and at least part-time employment (OR 2.12; 95% CI 1.66-2.72) were significantly associated with vaccine acceptance. Conclusions: COVID-19 vaccine nonacceptance in pregnant women is associated with Hispanic ethnicity and Black race, while acceptance is associated with Asian race, college education or more, at least part-time employment, and acceptance of the influenza vaccine. Future COVID-19 vaccination campaigns can target identified subgroups of pregnant women who are less likely to accept vaccination.

Ethnicity and participation in cancer self-help groups.

OBJECTIVES: Investigations of the benefits of membership of a cancer self-help group have suggested that it leads to improved sense of support, increased ability to deal with life-events, and decreased anxiety, confusion, depression and helplessness. However, some evidence suggests that people from black and ethnic groups are less likely to join a cancer self-help group. The main aims of the reported study were: to explore possible reasons why people from some ethnic groups have not participated in self-help to the same extent as the rest of the community; and to identify ways in which participation of people from ethnic groups can be increased. METHODS: A qualitative interview-based study of 68 people active in self-help was carried out as a partnership between an academic institution and a community organisation. RESULTS: A thematic analysis of the interview transcripts identified three main aspects of the value of being a member of a self-help group, regardless of interviewees' self-identified ethnicity: forming a sense of togetherness, learning from one other, and developing mutuality. We identify a number of reasons that discourage or encourage people from black and ethnic groups to join cancer self-help groups. CONCLUSION: We discuss some limits, identified by interviewees, that affect development of feelings of togetherness and mutuality and we conclude with some brief recommendations about widening participation in cancer self-help.