Antalya İli Merkez İlçelerindeki Aile Hekimlerine Kayıtlı, İkinci ve Üçüncü Trimesterdaki Gebelerin COVID-19’a Karşı Aşılanma Durumlarının ve Aşı Tereddütü Sebeplerinin Belirlenmesi

Gamze Akın Özkara; Mestan Emek; Fatma Karsavurdan; Emsal Çetin; Mehmet Rıfkı Aktekin

doi:10.53394/akd.1448959

Research Article

Antalya İli Merkez İlçelerindeki Aile Hekimlerine Kayıtlı, İkinci ve Üçüncü Trimesterdaki Gebelerin COVID-19’a Karşı Aşılanma Durumlarının ve Aşı Tereddütü Sebeplerinin Belirlenmesi

Year 2025, Volume: 11 Issue: 2, 216 - 222, 28.05.2025

Gamze Akın Özkara , Mestan Emek , Fatma Karsavurdan , Emsal Çetin , Mehmet Rıfkı Aktekin

https://doi.org/10.53394/akd.1448959

Abstract

Amaç: Gebelerin Covid-19’a yakalanma riski toplumla benzer olsa da benzer yaştaki gebe olmayan kadınlara göre ciddi hastalık geliştirme riskleri bulunmaktadır. Çalışmanın amacı; gebelerin Covid-19’a karşı aşılanma durumları, aşı tereddüdü sebeplerinin belirlenmesidir. Yöntem: Çalışma kesitsel tiptedir. Çalışma 01/12/2021-30/06/2022 tarihleri arasında yürütülmüştür. Hesaplanan katılımcı sayısına ulaşmak için merkez ilçelerdeki aile hekimleri basit rastgele örneklemeyle seçilmiştir. Çalışmanın bağımlı değişkeni Covid-19 aşısı olma durumu; bağımsız değişkenleri eğitim durumu, gelir durumu, Covid-19 geçirme ve aşılanma durumu, gebeyken Covid-19 aşısının önerilme durumu, önerildiyse kimin önerdiği, aşı yaptırmama nedenleridir. Analizler, SPSS 23.0 programında yapılmıştır. Tek değişkenli analizlerde Ki-kare ve Student t testi kullanılmıştır. Çok değişkenli analizde lojistik regresyon kullanılmış; p<0,05 anlamlı kabul edilmiştir. Bulgular: Gebelerin %67,8’ ine ulaşılmıştır (n=198). Katılımcıların yaş ortalaması 29,01±5,53’tür; %61,4’ü gebeliğin son trimesterindedir; %12,2’sinin bir kronik hastalığı vardır. Pandeminin başından beri gebelerin %31,2’si Covid-19 geçirmiştir; bunların %35’i Covid-19’u gebeyken geçirmiştir. Gebelerin %74,2’si en az bir doz Covid-19 aşısı yaptırmış; aşılananların %42,3’ü gebeyken aşılanmıştır. Gebelerin %25,2’si aşılanmamıştır; %20,7’sine Covid-19 aşısı önerilmemiştir. Aşılanmayan gebelerden, aşılanmama nedenini belirtenlerin en sık belirttiği iki neden; yan etkilerinden korkmak (%51,1), bebeğin olumsuz etkilenme ihtimalinden korkmaktır (%24,4). Çok değişkenli analiz sonucuna göre aşı önerilmeyen gebelerde Covid-19 aşısı yaptırmama 8,35 kat fazla bulunmuştur (p=,001; %95 GA:2,40-28,98). Sonuç: Gebelerin %25,8’i, gebelik döneminde aşılanmamış; %20,7’sine hiç aşı önerilmemiştir. Hâlâ ciddi sayıda gebe ve bebeği risk altındadır. Pandemi gibi yüksek riskli bir durumda; gebeler yakından takip edilmeli, aşısız olmalarına ‘sıfır tolerans’ yaklaşımı benimsenmelidir. Aşılanmanın arttırılabilmesi için sağlık çalışanlarının aşıyı önermesinin önemi büyüktür.

Keywords

COVID-19, COVID-19 aşısı, Pandemi, Gebelik

Thanks

Çalışma için gerekli izin ve onayların alınmasındaki destekleri için Antalya İl Sağlık Müdürlüğü Halk Sağlığı Başkanı Dr. Hacer Nur Yüce ve Başkan Yardımcısı Dr. Saniye Gülatan’a; gebelere erişimi kolaylaştırdıkları için örnekleme çıkan aile hekimleri ve aile sağlığı elemanlarına teşekkür ederiz.

References

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14. Türkiye Maternal Tıp ve Perinatoloji Derneği. Gebelerde ve Emziren Annelerde COVID-19 Aşıları ile İlgili Türkiye Maternal Tıp ve Perinatoloji Derneği Görüşü. 2021 [Available from: https://www.tmftp.org/files/uzman-gorusleri/gebelerde_covid19_asisi.pdf (Erişim Tarihi: 06.03.2022)].
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22. Kalok A, Razak Dali W, Sharip S, Abdullah B, Kamarudin M, Dasrilsyah RA, Abdul Rahman R, Kamisan Atan I. Maternal COVID-19 vaccine acceptance among Malaysian pregnant women: A multicenter cross-sectional study. Frontiers in Public Health 2023; 11:1092724.
23. Yasmin F, Najeeb H, Moeed A, Naeem U, Asghar MS, Chughtai NU, Yousaf Z, Seboka BT, Ullah I, Lin CY, Pakpour AH. COVID-19 vaccine hesitancy in the United States: a systematic review. Frontiers in public health 2021; 9:770985.
24. Levy AT, Singh S, Riley LE, Prabhu M. Acceptance of COVID-19 vaccination in pregnancy: a survey study. American journal of obstetrics & gynecology MFM 2021; 3(5):100399.
25. Wilson RJ, Paterson P, Jarrett C, Larson HJ. Understanding factors influencing vaccination acceptance during pregnancy globally: a literature review. Vaccine 2015; 33(47):6420-9.
26. Bhattacharya O, Siddiquea BN, Shetty A, Afroz A, Billah B. COVID-19 vaccine hesitancy among pregnant women: A systematic review and meta-analysis. BMJ open 2022; 12(8):e061477.
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36. Razzaghi, H, Kahn KE, Calhoun K, Garacci E, Skoff,TH., Ellington SR, Jatlaoui TC, Black CL. (2023). Influenza, Tdap, and COVID-19 Vaccination Coverage and Hesitancy Among Pregnant Women- United States, April 2023. MMWR. Morbidity and mortality weekly report 2023; 72(39):1065–71.

Determination of Vaccination Status of 2nd and 3rd Trimester Pregnant Women Registered to Family Physicians in the Central Districts of Antalya Province Against Covid-19 and Reasons for Vaccination Hesitation

Year 2025, Volume: 11 Issue: 2, 216 - 222, 28.05.2025

Gamze Akın Özkara , Mestan Emek , Fatma Karsavurdan , Emsal Çetin , Mehmet Rıfkı Aktekin

https://doi.org/10.53394/akd.1448959

Abstract

Objective: Although the risk of Covid-19 in pregnant women is similar to that of the general population, they have a higher risk of developing serious diseases compared to non-pregnant women of similar age. The aim of the study was to determine the vaccination status of pregnant women against Covid-19 and the reasons for vaccination hesitation. Method: The study is cross-sectional. It was conducted between 01/12/2021-30/06/2022. Family physicians in the central districts were selected by simple random sampling to reach the calculated number of participants. The dependent variable of the study was Covid-19 vaccination status; the independent variables were educational status, income status, Covid-19 exposure and vaccination status, Covid-19 vaccination recommendation while pregnant, if recommended, who recommended it, and reasons for not getting vaccinated. Analyses were performed in SPSS 23.0 programme. Chi-square and Student t test were used in univariate analyses. Logistic regression was used in multivariate analyses; p<0.05 was considered significant. Results: 67.8% of the pregnant women were reached (n=198). The mean age of the participants was 29.01±5.53 years; 61.4% were in the last trimester of pregnancy; 12.2% had a chronic disease. Since the beginning of the pandemic, 31.2% of pregnant women had Covid-19; 35% of them had Covid-19 while pregnant. 74.2% of pregnant women received at least one dose of Covid-19 vaccine; 42.3% of those vaccinated were vaccinated while pregnant. 25.2% of pregnant women were not vaccinated; 20.7% were not offered Covid-19 vaccine. Among the unvaccinated pregnant women, the two most frequently cited reasons for not being vaccinated were fear of side effects (51.1%) and fear of the possibility of adverse effects on the baby (24.4%). According to the results of multivariate analysis, not getting Covid-19 vaccine was found to be 8.35 times higher in pregnant women for whom vaccination was not recommended (p=.001; 95% CI: 2.40-28.98). Conclusion: 25.8% of pregnant women were not vaccinated during pregnancy and 20.7% were not offered any vaccine. A significant number of pregnant women and their babies are still at risk. In a high-risk situation such as a pandemic, pregnant women should be closely monitored and a 'zero tolerance' approach should be adopted. In order to increase vaccination, it is of great importance for healthcare professionals to recommend the vaccine.

Keywords

COVID-19, COVID-19 vaccine, Pandemic, Pregnancy

References

1. World Health Organization (WHO). 2019 Novel Coronavirus (2019 nCoV): Strategic Preparedness and Response Plan. 2020.
2. World Health Organization (WHO). Archived: WHO Timeline - COVID-19 2020 .[Available from: https://www.who.int/news/item/27-04-2020-who-timeline-COVID-19 Erişim Tarihi: 21.04.2022].
3. World Health Organization (WHO). WHO’s response to COVID-19-2021 Annual Report. Strategic Health Operations; 2022.
4. World Health Organization (WHO). WHO Coronavirus (COVID-19) Dashboard: WHO; 2023 [Available from: https://covid19.who.int/region/euro/country/tr Erişim tarihi: 20.03.2024].
5. Centers for Disease Control and Prevention. Science Brief: Evidence Used to Update the List of Underlying Medical Conditions Associated with Higher Risk for Severe COVID-19. 2022.
6. World Health Organization (WHO). Pregnancy, childbirth and the postnatal period. WHO; 2022.
7. National Health Service. Pregnancy, breastfeeding, fertility and coronavirus (COVID-19) vaccination 2022 [Available from: https://www.nhs.uk/pregnancy/keeping-well/pregnancy-breastfeeding-fertility-and-covid-19-vaccination/ (Erişim Tarihi:01.01.2024)].
8. The Royal College of Obstetricians and Gynaecologists (RCOG). COVID-19 vaccines, pregnancy and breastfeeding FAQs 2022 [Available from: https://www.rcog.org.uk/guidance/coronavirus-covid-19-pregnancy-and-women-s-health/vaccination/covid-19-vaccines-pregnancy-and-breastfeeding-faqs/ (Erişim tarihi 26.07.2022)].
9. Royal College of Obstetricians & Gynaecologists, Royal College of Midwives, UK Teratology Information Service, MacDonald Obstetric Medicine Society. Information sheet and decision aid 2021 [Available from: https://www.rcm.org.uk/media/4963/combined-info-sheet-and-decision-aid-13052021.pdf (Erişim tarihi: 23.07.2022)].
10. Jamieson DJ, Rasmussen SA. An update on COVID-19 and pregnancy. American journal of obstetrics and gynecology. 2021.
11. Centers for Disease Control and Prevention. Pregnant and Recently Pregnant People. 2022.
12. Gurol-Urganci I, Jardine JE, Carroll F, Draycott T, Dunn G, Fremeaux A, Harris T, Hawdon J, Morris E, Muller P, Waite L, Webster K, van der Meulen J, Khalil A. Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection at the time of birth in England: national cohort study. American journal of obstetrics and gynecology 2021; 225(5):522. e1-e11.
13. Kılınçdemir Ü, Bayhan G. COVID-19 Enfeksiyonu ile Komplike Gebe Hastalarda Maternal ve Neonatal Sonuçların Değerlendirilmesi. SDÜ Tıp Fakültesi Dergisi 2021; 28(COVİD-19 ÖZEL SAYI):119-24.
14. Türkiye Maternal Tıp ve Perinatoloji Derneği. Gebelerde ve Emziren Annelerde COVID-19 Aşıları ile İlgili Türkiye Maternal Tıp ve Perinatoloji Derneği Görüşü. 2021 [Available from: https://www.tmftp.org/files/uzman-gorusleri/gebelerde_covid19_asisi.pdf (Erişim Tarihi: 06.03.2022)].
15. T.C. Sağlık Bakanlığı. Sıkça Sorulan Sorular 29. COVID-19 mRNA aşısı gebelere uygulanabilir mi? [Available from: https://covid19asi.saglik.gov.tr/TR-85130/29-covid-19-mrna-asisi-gebelere-uygulanabilir-mi.html#:~:text=Gebelikte%20COVID%2D19%20mRNA%20a%C5%9F%C4%B1s%C4%B1n%C4%B1n,gebelere%20a%C5%9F%C4%B1%20uygulanmas%C4%B1%20tavsiye%20edilmektedir. Erişim Tarihi: 02.04.2023].
16. Centers for Disease Control and Prevention. V-safe COVID-19 Vaccine Pregnancy Registry.2022. [Available from: https://www.cdc.gov/vaccinesafety/ensuringsafety/monitoring/v-safe/covid-preg-reg.html (Erişim Tarihi: 03.01.2023)].
17. Centers for Disease Control and Prevention. Talking with Patients about COVID- Vaccination. 2021. [Available from: https://www.cdc.gov/vaccines/covid-19/hcp/engaging-patients.html#:~:text=Say%20something%20like%2C%20%E2%80%9CIf%20it,vaccines%20at%20a%20future%20time.%E2%80%9D (Erişim Tarihi: 02.02.2022)].
18. NTV. Bir ölüm daha: Aşısız hamile corona virüse yenildi. 2021. [Available from: https://www.ntv.com.tr/turkiye/bir-olum-daha-asisiz-hamile-corona-viruse-yenildi,ASEhatfsTEmzBF9P6cBAZw (Erişim Tarihi: 13.01.2022)].
19. T.C. Sağlık Bakanlığı. T.C. Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı 2020. Ankara 2022.
20. HASUDER Bulaşıcı Hastalıklar Çalışma Grubu. Covid-19 Pandemisinde Güncel Durum ve Öneriler. 2022. [Available from: https://hasuder.org/Duyurular/Detay/basin-bildirileri/covid-19-pandemisinde-guncel-durum-ve-oneriler/0de0bf33-ea27-1032-3bf1-3a0492d70a09 (Erişim Tarihi: 23.05.2024)].
21. Riad A, Jouzová A, Üstün B, Lagová E, Hruban L, Janků P, Pokorná A, Klugarová J, Koščík M, Klugar M. COVID-19 vaccine acceptance of pregnant and lactating women (PLW) in Czechia: an analytical cross-sectional study. International Journal of Environmental Research and Public Health 2021; 18(24):13373.
22. Kalok A, Razak Dali W, Sharip S, Abdullah B, Kamarudin M, Dasrilsyah RA, Abdul Rahman R, Kamisan Atan I. Maternal COVID-19 vaccine acceptance among Malaysian pregnant women: A multicenter cross-sectional study. Frontiers in Public Health 2023; 11:1092724.
23. Yasmin F, Najeeb H, Moeed A, Naeem U, Asghar MS, Chughtai NU, Yousaf Z, Seboka BT, Ullah I, Lin CY, Pakpour AH. COVID-19 vaccine hesitancy in the United States: a systematic review. Frontiers in public health 2021; 9:770985.
24. Levy AT, Singh S, Riley LE, Prabhu M. Acceptance of COVID-19 vaccination in pregnancy: a survey study. American journal of obstetrics & gynecology MFM 2021; 3(5):100399.
25. Wilson RJ, Paterson P, Jarrett C, Larson HJ. Understanding factors influencing vaccination acceptance during pregnancy globally: a literature review. Vaccine 2015; 33(47):6420-9.
26. Bhattacharya O, Siddiquea BN, Shetty A, Afroz A, Billah B. COVID-19 vaccine hesitancy among pregnant women: A systematic review and meta-analysis. BMJ open 2022; 12(8):e061477.
27. Schmid P, Rauber D, Betsch C, Lidolt G, Denker M-L. Barriers of influenza vaccination intention and behavior–a systematic review of influenza vaccine hesitancy, 2005–2016. PloS one 2017; 12(1): e0170550.
28. Mohan S, Reagu S, Lindow S, Alabdulla M. COVID-19 vaccine hesitancy in perinatal women: a cross sectional survey. Journal of perinatal medicine 2021; 49(6):678-85.
29. Sutton D, D'Alton M, Zhang Y, Kahe K, Cepin A, Goffman D, Staniczenko A, Yates H, Burgansky A, Coletta J, Williams Z, Gyamfi-Bannerman C. COVID-19 vaccine acceptance among pregnant, breastfeeding, and nonpregnant reproductive-aged women. American journal of obstetrics & gynecology MFM 2021; 3(5):100403.
30. Januszek SM, Faryniak-Zuzak A, Barnaś E, Łoziński T, Góra T, Siwiec N, Szczerba P, Januszek R, Kluz T. The approach of pregnant women to vaccination based on a COVID-19 systematic review. Medicina 2021; 57(9):977.
31. Saitoh A, Takaku M, Saitoh A. High rates of vaccine hesitancy among pregnant women during the coronavirus disease 2019 (COVID-19) pandemic in Japan. Human Vaccines & Immunotherapeutics 2022; 18(5):2064686.
32. Hervenak FA, McCullough LB, Bornstein E, Johnson L, Katz A, McLeod-Sordjan R, Nimaroff M, Rochelson BL, Tekbali A, Warman A, Williams K, Grünebaum A. Professionally responsible coronavirus disease 2019 vaccination counseling of obstetrical and gynecologic patients. American journal of obstetrics and gynecology 2021; 224(5):470-8.
33. Wilcox CR, Bottrell K, Paterson P, Schulz WS, Vandrevala T, Larson HJ, Jones CE. Influenza and pertussis vaccination in pregnancy: portrayal in online media articles and perceptions of pregnant women and healthcare professionals. Vaccine 2018; 36(50):7625-31.
34. Wilcox CR, Calvert A, Metz J, Kilich E, MacLeod R, Beadon K, Heath PT, Khalil A, Finn A, Snape MD, Vandrevala T, Nadarzynski T, Coleman MA, Jones CE. Determinants of influenza and pertussis vaccination uptake in pregnancy: a multicenter questionnaire study of pregnant women and healthcare professionals. The Pediatric infectious disease journal 2019; 38(6):625-30.
35. Abuhammad S. Attitude of pregnant and lactating women toward COVID-19 vaccination in Jordan: a cross-sectional study. Journal of Perinatal Medicine. 2022; 50(7):896-903.
36. Razzaghi, H, Kahn KE, Calhoun K, Garacci E, Skoff,TH., Ellington SR, Jatlaoui TC, Black CL. (2023). Influenza, Tdap, and COVID-19 Vaccination Coverage and Hesitancy Among Pregnant Women- United States, April 2023. MMWR. Morbidity and mortality weekly report 2023; 72(39):1065–71.

There are 36 citations in total.

Details

Primary Language	Turkish
Subjects	Preventative Health Care, Public Health (Other)
Journal Section	Research Article
Authors	Gamze Akın Özkara 0000-0003-4555-6064 Mestan Emek 0000-0001-6843-4954 Fatma Karsavurdan 0009-0000-4166-6405 Emsal Çetin 0000-0001-5438-0836 Mehmet Rıfkı Aktekin 0000-0002-0745-9194
Early Pub Date	May 22, 2025
Publication Date	May 28, 2025
Submission Date	March 22, 2024
Acceptance Date	July 8, 2024
Published in Issue	Year 2025 Volume: 11 Issue: 2

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Vancouver	Akın Özkara G, Emek M, Karsavurdan F, Çetin E, Aktekin MR. Antalya İli Merkez İlçelerindeki Aile Hekimlerine Kayıtlı, İkinci ve Üçüncü Trimesterdaki Gebelerin COVID-19’a Karşı Aşılanma Durumlarının ve Aşı Tereddütü Sebeplerinin Belirlenmesi. Akd Med J. 2025;11(2):216-22.

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