RESUMO
Objective: The rate of COVID-19 vaccination hesitation among Iranian pregnant women is around 50%. The objective of the present study was to determine the reasons for the refusal of COVID-19 vaccination among pregnant and postpartum women. Materials and methods: This descriptive cross-sectional study was performed on 304 pregnant and postpartum women in the comprehensive health centers of Yazd, Iran, between October 2022 and April 2023. Researchers collected the data of unvaccinated women through phone calls using a validated questionnaire. Data was collected using a questionnaire consisting of baseline characteristics and reasons for refusing vaccination. Descriptive statistics were used to analyze the data using SPSS version 22. Results: The mean age of the pregnant and postpartum women participating in this study was 28.31 ± 6.47 years. The most common reasons for refusing the COVID-19 vaccine included fear of harming the fetus (32.2%), fear of side effects in the mother (25.7%), disbelief in COVID-19 disease and vaccine (13.8%), lack of information about the vaccine (12.8%), and negative opinions of the media and society (12.8%). Less common reasons included husband's disagreement (8.2%), history of COVID-19 infection (6.9%), gynecologists' disagreement (6.3%), history of infertility (5.9%), and underlying disease (3.3%). Astonishingly, among participants who did not inject a booster dose of the vaccine, 76% reported they didn't receive any training and recommendation on booster dose injection from health providers. Conclusion: Findings highlight that the most common reasons for refusing the COVID-19 vaccine were fear of harming the fetus and fear of side effects in the mother.
RESUMO
Background: The COVID-19 epidemic control has become a global challenge and many contributing variables are still unknown to policymakers. This case-cohort study was conducted to investigate the risk factors of mortality in COVID-19 patients. Methods: This case-cohort study was conducted on 956 samples in Ardakan and Meybod counties, Yazd Province, between February 20 and May 20, 2020. The data collection tool was a researcher-made questionnaire. Data analysis was done using descriptive statistics and paired t-test, chi-square, and logistic regression analysis. Results: Of a total cohort population of 993 in Ardakan and Meybod counties, 435 were assigned to the control group and 521 were assigned to the case group. The results of outcome analysis showed that 14.4% of the patients in the case group and 11.5% of the patients in the control group died. According to the results of logistic regression analysis in COVID-19 patients, each one-year increase in age increased the risk of mortality by 6% (HR = 1.06, p < 0.001), each one-day increase in the hospital stay increased the risk of death by 8% (HR = 1.08, p < 0.001). Moreover, the presence of cardiovascular disease, chronic neurological disease, and chronic pulmonary disease increased the risk of death. The patients who underwent mechanical ventilation had 85% less chance of survival (HR = 0.15, p < 0.001). Conclusions: The results showed a higher mortality rate in the elderly patients as well as those with underlying diseases. Attention should be paid to at-risk and elderly patients in terms of ensuring a healthy diet, improving their self-care practices, and providing long-term medical and healthcare facilities.