Covid-19 Vaccine Recommendation Opinions of Nursing/midwifery Students to Women of Reproductive Age

doi:10.21203/rs.3.rs-2124152/v1

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Covid-19 Vaccine Recommendation Opinions of Nursing/midwifery Students to Women of Reproductive Age

https://doi.org/10.21203/rs.3.rs-2124152/v1

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Nursing and midwifery students are an important resource in increasing COVID-19 vaccine acceptance among women of reproductive age. In this study, it was aimed to determine the thoughts of midwifery and nursing senior students to recommend COVID-19 vaccine to women of reproductive age and related factors. The data of the cross-sectional study were collected from 504 midwifery and nursing senior students across Türkiye between March 15th - April 30th, 2022, using the "Individual Identification Form", "Vaccine Opinion Form" and "Scale of Attitudes towards COVID-19 Vaccine" in the online environment with snowball sampling method. Data were evaluated with t test, chi-square analysis, correlation analysis, ANOVA, logistic regression, and decision tree analysis. Of the students, 84.3% were women, 50.2% were in the nursing department, and 97.6% had at least two doses of COVID-19 vaccine. While 44.4% of the students stated that they would not recommend vaccination to any of the women that pregnant, breastfeeding and planning to pregnancy, 22.6% reported that they could recommend the COVID-19 vaccine to all three groups. Students who thought they could be counselled on vaccines and had received a previous flu shot were more likely to recommend a COVID-19 vaccine, while students who did not find vaccines safe and believed they could be harmful and did not receive adequate training on vaccines were less likely to recommend vaccines. Counselling self-efficacy of students was affected by education and up-to-date information. It is recommended to develop knowledge and counselling skills so that nursing and midwifery students can recommend COVID-19 vaccine to women of reproductive age.

COVID-19 vaccine

nursing

midwifery

students

pregnant

breastfeeding

vaccine recommendation

Counselling self-efficacy

Although the World Health Organization (WHO) and numerous international organizations promote the COVID-19 vaccine, immunization rates among women of reproductive age are low, and vaccination hesitancy is high (Chervenak et al., 2021; Giles et al., 2021; International Federation of Gynecology and Obstetrics, 2021; World Health Organization, 2014). Since pregnant and breastfeeding women are often omitted from clinical trials, the lack of data on the efficacy and safety of vaccinations in this group, as well as women's concerns about fertility, are among the main causes of vaccine instability (Carbone et al., 2022; Goncu Ayhan et al., 2021; Oluklu et al., 2021; Shamshirsaz et al., 2022; Skjefte et al., 2021; Ward et al., 2022). Because of the increased risk of getting COVID-19 and suffering problems, women of reproductive age who are pregnant, breastfeeding, or planning to become pregnant should be counselled about COVID-19 immunizations (Giles et al., 2021; Chervenak et al., 2021; Joubert et al., 2022). Nursing and midwifery students, who are at the forefront during the pandemic process, are as key as the staff working in the field for COVID-19 vaccine counselling (Burden et al., 2021; World Health Organization, 2022). It is important that students gain knowledge and counselling skills about vaccines during their education.

Nursing and midwifery students who participated in one-on-one service delivery in many areas during the pandemic and trained in clinics and in the field (primary care) are an important resource in building confidence in the community and women of reproductive age, although the studies conducted with this group are confined to acceptance status and vaccination attitudes (Jiang et al., 2021; Manning et al., 2021; Patwary et al., 2022; The International Council of Nurse, 2022; Yesiltepe et al., 2021). There was not enough data on whether students are competent to provide vaccination counselling competency, how they evaluate vaccination at the reproductive age, and whether they would recommend a COVID-19 vaccine (Bradfield et al., 2021). It is important in terms of evaluating the factors that may affect the vaccination recommendation behaviors of nursing and midwifery students, which are an important resource for increasing the vaccination rates in the community and updating the content of vocational training. In this study, we aimed to evaluate the factors that may affect the thoughts and counselling competency of nursing and midwifery senior students to recommending COVID-19 vaccine to women of reproductive age.

This cross-sectional research was conducted between March 15th - April 30th, 2022.

Participants

Nursing and midwifery programs in Turkish universities offer four-year undergraduate education. The study was conducted online with senior students from Turkish universities' midwifery and nursing departments. In calculating the sample size, students recommended COVID-19 immunization to pregnant women at a rate of (Bradfield et al., 2021) 20%, with a 5% sampling error, a 95% confidence level, a pattern effect of 2 calculated in the Epi info program, and a minimum sample size of 492. Midwifery and nursing programs in Turkish universities offer four-year undergraduate education. The study included students in their final year of an undergraduate midwifery or nursing program. The data were collected online by snowball sampling method. A web survey with informed consent was distributed to midwifery and nursing students' social media accounts. The research was completed with 504 students. To conduct the study, the University Social and Human Sciences Ethics Committee (03.03.2022/74) granted ethical approval. No personal data was recorded in the survey form.

Instrument and data collection

The study's results were collected using the "Individual Identification Form," the "Vaccine Opinion Form," and the "Attitudes Towards COVID-19 Vaccine Scale."

Individual Identification Form: It consisted of ten questions covering age, gender, COVID-19 disease and vaccination history, influenza vaccination, counselling self-efficacy, COVID-19 vaccine training, and following up-to-date vaccine information.

Attitudes Towards COVID-19 Vaccine Scale: Genis et al. (2020) devised a 5-point Likert-type scale (1 strongly disagree- 5 strongly agrees), with two sub-dimensions: positive (4 items)/negative attitude (5 items) [negative attitude (reverse coded)] as well as a total of 9 items. The scale is not used to determine the total score, and the sub-dimension scores are obtained by averaging the items in the sub-dimension. High values in the "positive attitude" sub-dimension are regarded as "positive attitude" toward the vaccine, whereas high scores in the "negative attitude" sub-dimension are interpreted as "low negative attitude" against the vaccine (Genis at al., 2020). The Cronbach Alpha coefficient in Geniş et al (2020)'s study was 0.96 for the positive attitude sub-dimension and 0.78 for the negative attitude, whereas the Cronbach Alpha coefficients in our study were 0.901 and 0.778, respectively.

Opinion Form Regarding COVID-19 Vaccines in Reproductive Age: The form created by the researchers after a thorough review (Bradfield et al., 2021; Deruelle et al., 2021; Lutz et al., 2018) of the material is divided into two sections. The phrase "reproductive age" was used in this study to refer to women who were "pregnant," "breastfeeding," or "planned to become pregnant." There were seven statements in the first section of the form about the status of recommending vaccines based on the attitude toward the adequacy and reliability of the research results, as well as the negative effects of the vaccine on "women planning to become pregnant, pregnant women, baby, breastfeeding." Each statement was answered as "I agree", "I disagree" and "I have no information". Opinions and statements that may have a side effect on vaccine recommendations were assigned "0" points, whereas positive opinions were assigned "1" points, and all statements were gathered. The obtained "opinion on COVID-19 vaccines in the reproductive age" ranged from 0 to 7. The increase in score was interpreted as a positive view of COVID-19 vaccines. The KR-20 of this section was 0.822.

The second section included five questions about pregnant and breastfeeding women's views on COVID-19 vaccination and recommending the COVID-19 vaccine to women with pregnant, breastfeeding, and planning to pregnancy. The status of vaccine recommendation was given as "1: I absolutely do not suggest it, 2: I cannot recommend it because I lack expertise, 3: I only recommend it to high-risk women and 4: I definitely recommend it." Vaccine recommendation status was scored as "I definitely do not recommend and cannot recommend it because I do not have information," those who were scored as “did not recommend (0)”; the answers were scored as "I definitely recommend it and only recommend it to high-risk people," and those who were scored as “did recommend (1)”. Furthermore, responses were gathered to determine the status of recommended immunization to all categories of women of reproductive age (women who were pregnant, breastfeeding, and planning to become pregnant). Those with three points were recoded as "recommending to all groups," while those with zero points were recoded as "not recommending to any group." The content validity of the form was evaluated by five expert midwives and nurses. Three items were corrected, no questions were removed or added. The content validity of the form was calculated as 0.98 with the Davis technique.

Data analysis

On a statistical package program, the data were examined using descriptive statistics, chi-square, t-test, correlation analysis, ANOVA, Binary Logistic Regression, and decision tree analysis. The normality of the distribution was evaluated with Skewness and Kurtosis.

Logistic regression analysis (enter method) was used to determine the factors affecting the probability of recommending the COVID-19 vaccine to at least one group of pregnant or breastfeeding women or planning to pregnancy among women of reproductive age. Predicted variables include recommending vaccination to at least one group, gender as a predictive variable, department, having COVID-19 three dose (booster doses), receiving flu vaccine, having COVID-19, following up-to-date information about COVID-19 vaccines, receiving education, subjective counselling self-efficacy, positive and negative attitude scores towards COVID-19 vaccines, and opinion items about COVID-19 vaccines in the reproductive age. In the decision tree analysis performed to examine the variables predicting counselling self-efficacy, the CHAID (Chi-squared Automatic Interaction Detection) model was applied. Counselling self-efficacy was added to the model as a dependent variable, and gender, department, having COVID-19, having COVID-19 vaccine and flu vaccine, experiencing post-vaccine side effects, receiving education, following up-to-date information, and positive and negative attitudes toward COVID-19 vaccine attitude scores were added to model as independent variable. 50% of the data set was run as scanning and 50% as testing. P ≤ 0.05 was considered significant in all analyses.

The median age of the 504 students in the study was 22.00 years, 84.3% were female, 50.2% were in the nursing department, and 53.2% had received three doses, and 44.4% two doses of COVID-19 vaccination, while 80.5% had never did not receive the flu vaccine. Only 9.9% of the students thought they were competent to counselling women of reproductive age about COVID-19 vaccines, while 57.4% were unsure, 32.7% thought they could not. While only 20.0% of the students received training on COVID-19 vaccines, 53.8% were following the current developments in vaccines. Positive (3.46 ± 1.06; min1-5) and negative (3.52 ± 0.82) attitudes towards the COVID-19 vaccine were moderate.

44.4% of the students stated that they would not recommend COVID-19 vaccine to any group of reproductive age, 15.5% of them would recommend at least one, 17.5% of them at least two, and 22.6% of them would recommend vaccination to all groups of reproductive age. Most of the students stated that they would not recommend it because they did not have knowledge about the subject (Graphic 1).

Binary Logistic Regression Analysis was found to be significant in evaluating the elements influencing the concept of recommending COVID-19 vaccine to women of reproductive age (X2: 154.570; P ≤ 0.001). The model correctly classifies the probability of recommending a COVID-19 vaccine as 35.4% (Nagelkerke R2:0.354). Those who believe they can counsel on COVID-19 vaccinations are more inclined to recommend them (OR: 2.788; 95% Cl, 1.122–6.925), as are those who have previously received influenza vaccines (OR: 1.784; 95% Cl, 1.021–3.116). Those who disagree with the view that the WHO-approved COVID-19 vaccines are safe for pregnant women (OR: 0.516; 95% Cl, 0.300- 0.887), those who believe that the research showing the vaccine's effectiveness in pregnant women is insufficient (OR: 0.432; 95% Cl, 0.203–0.920), those who believe that the COVID-19 vaccines will cause serious side effects in pregnant women (OR: 0.524; 95% Cl, 0.278–0.986) and that the vaccine will harm the baby (OR:0.344; 95% Cl, 0.178–0.667), and those who lack training in the field are less likely to recommend the COVID-19 vaccine (OR: 0.490; 95% Cl, 0.281–0.855) (Table 1).

Table 1

Evaluation of factors affecting students' probability of recommending vaccines by “binary logistic regression analysis”.
	B	Sig.	Exp(B)	95% C.I.for EXP(B)
Gender (Ref: male )	-0.343	0.296	0.709	0.373–1.351
Department (Ref: midwife )	0.198	0.455	1.219	0.725–2.050
Infected with COVID-19 ( Ref: Yes)	0.203	0.374	1.225	0.783–1.915
The status of having the reminder dose of the COVID-19 vaccine. (Ref: The person who have the booster dose.)	0.131	0.587	1.140	0.710–1.829
Influenza vaccination status (Ref: vaccinated)	0.579	0.042	1.784	1.021–3.116
Up-to-date information on COVID-19 vaccines (Ref: not doing)	0.313	0.158	1.367	0.886–2.110
Get education on COVID-19 vaccines ( Ref: not get )	-0.713	0.012	0.490	0.281–0.855
Perceived competence in COVID-19 vaccines (Ref: can be )	1.025	0.027	2.788	1.122–6.925
Positive attitude score towards COVID-19 vaccine	0.010	0.943	1.010	0.769–1.327
Negative attitude score towards COVID-19 vaccine	0.054	0.758	1.055	0.749–1.487
I think that the COVID-19 vaccines approved by the World Health Organization are safe for pregnant women. (Ref: I don’t agree)	-0.663	0.017	0.516	0.300- 0.887
The recommendation of international guidelines to vaccinate pregnant women for COVID-19 allows me to safely recommend vaccination to pregnant women. (Ref: I don’t agree)	-0.399	0.114	0.671	0.409- 1.100
I am of the opinion that the research results showing the effectiveness of the vaccine in pregnant women are sufficient. (Ref: I don’t agree)	-0.840	0.029	0.432	0.203–0.920
I am of the opinion that COVID-19 vaccines will cause serious side effects in pregnant women compared to non-pregnant women. (Ref: I agree)	-0.647	0.045	0.524	0.278–0.986
I think COVID-19 vaccines will harm the baby (Ref: I agree)	-1.066	0.002	0.344	0.178–0.667
I think COVID-19 vaccines will cause infertility (Ref: I agree)	-0.364	0.140	0.695	0.429–1.126
I think that mothers who have had the COVID-19 vaccine should not breastfeed for a certain period of time (Ref: I agree)	-0.186	0.514	0.830	0.475–1.451
Constant	-0.801	0.312	0.449
* Evaluation was made according to the vaccination recommendation status in at least one of the planning to pregnancy, pregnancy or breastfeeding periods.

Counselling competency related to obtaining training and following up-to-date information, according to the results of the decision tree analysis in which the variables influencing the counselling competency of the students were analysed. The probability of explaining the counselling competency of the model was 50.0%. According to the model, the rate of those who thought that they could provide counselling was higher among those who received training on vaccines compared to those who did not. On the other hand, among those who did not receive training, the rate of those who thought that they could provide counselling was higher among those who followed up-to-date information (P < 0.05,) (Fig. 1).

This is the first study, which to evaluate the factors influencing nursing and midwifery students' attitudes toward recommending the COVID-19 vaccine to women of reproductive age and counselling self-efficacy, is significant in terms of highlighting the need for students to develop knowledge and counselling skills on the subject.

It is stated that the rate of women of reproductive age accepting the COVID-19 vaccine is lower than the general population, and it is critical for these women to receive counselling and advice from health personnel not only in accepting the COVID-19 vaccine, but also in accepting other vaccines developed during this time period ( Castillo et al., 2021; Chervenak et al., 2021; Januszek et al., 2022; Lutz et al., 2018; Nindrea et al., 2022; Ward et al. 2022). However, students, like other healthcare professionals, do not have a high rate of contemplating recommending COVID-19 vaccine to pregnant, breastfeeding, or planning to become pregnant women (Bradfield et al. 2021; Deruelle et al. 2021; Daskalakis et al. 2022). In Bradfield et al. (2021)'s study, the rate of midwifery students recommending the COVID-19 vaccine to those planning pregnancy and pregnant women was similar to the current study (17.9% − 28.6%, respectively), while the rate of those who said they would not (39.3% − 35.7%) was higher (Bradfield et al., 2021). The decrease in the rate of not recommending the vaccine may be due to the growing evidence regarding vaccine efficacy and safety over the course of a year. Although no further research with students have been published, studies with other healthcare workers in prenatal care show that obstetricians and medical practitioners prescribe COVID-19 vaccination at a higher rate than midwives and nurses (Bradfield et al. 2021; Deruelle et al., 2021; Daskalakis et al., 2022). In the present study, there is no difference between nursing and midwifery students' vaccination recommendation status. It is encouraging that the percentage of students in both groups who said they would never suggest vaccination to any woman of reproductive age is low.

Strong vaccination recommendations from health professionals may enhance immunization rates among women of reproductive age (Castillo et al., 2021; Chervenak et al., 2021; Januszek et al., 2022; Ward et al., 2022;). However, a lot of factors influence health professionals' recommendations for vaccination to their patients. Similarly to literature, the findings of the current study, students who had previously received influenza vaccine were 1.8 times more likely to recommending to vaccine (Lutz et al., 2018). In general, a positive attitude toward vaccinations, particularly COVID-19 vaccines, is said to influence vaccination recommendations (Deruelle et al., 2021; Massot and Epaulard, 2018). Similarly to literature, although the rate of those who recommend vaccines is high among students who have a positive attitude toward the COVID-19 vaccine, it is seen that a positive attitude toward vaccination alone is not sufficient in vaccine proposal, while not receiving training on the subject reduces the possibility of recommending vaccines, and believing they have the competence to advise increases the possibility of recommending vaccines 2.8 times. According to the literature and our study's findings, students' counselling skills, as well as the transfer of information about them, should be enhanced.

Students need specialized knowledge and counselling skills to counsel women of reproductive age (Berenson et al., 2021; Burden et al., 2021; Castillo et al., 2021; Lutz et al., 2018). In the current study, however, a considerable number of students claimed that they were not qualified to counselling for vaccine and that they could not recommend the vaccines to these groups since nearly half of them had not adequate knowledge on the matter. Although the authority and facilities of midwives and nurses to prescribe and administer vaccines vary by country, it has been reported in the literature that midwives and nurses who are knowledgeable about vaccines during the reproductive period and have received vaccine training are more likely to advise and recommend vaccines (Bisset and Paterson, 2018; Krishnaswamy et al., 2018; Massot and Epaulard, 2018; Vishram et al., 2018). Only one-fifth of the students in the current study reported having received COVID-19 vaccination training. Corresponding to the literature, it was discovered that students who had not received vaccination training were less recommended the vaccination. The inclusion of vaccinations and reproductive age vaccines in general, and COVID-19 vaccines in particular, in nursing and midwifery curriculum may make students feel more comfortable in consulting by boosting their knowledge level (Berenson et al., 2021; Massot and Epaulard, 2018).

Knowledge and application skills are important in the development of counselling competence. According to the study's findings, counselling competency is related to obtaining training and following up on current knowledge, which is consistent with the literature (Berenson et al., 2021; Chang et al., 2022). Developing short interventions based on the causes of vaccine instability in women of reproductive age, teaching students how to use motivational interview techniques, and providing students with the opportunity to apply what they have learned with the simulated patient or role play method before going to field practice can all contribute to the development of vaccine counselling skills (Bisset and Paterson, 2018; Castillo et al., 202; Chang et al., 2022; Ward et al., 2022). It is important for students to follow up-to-date information. However, students may not always be able to acquire reliable material with a high degree of proof, despite their desire to follow up-to-date information in the quickly changing information flow and infodemic environment during the pandemic era. Students should be instructed on how to write guides and research results with a high level of evidence.

Concerns about vaccine safety and efficacy, the danger of injuring the infant, and fear of adverse effects are among the reasons why pregnant and breastfeeding women decline the COVID-19 vaccine (Castillo et al., 2021; Goncu Ayhan et al., 2021; Januszek et al., 2022; Nindrea et al., 2022; Oluklu et al., 2021; Skjefte et al., 2021; Ward et al., 2022). It is seen that healthcare professionals caring for women of reproductive age have similar concerns; it is seen that the idea that vaccines are not safe for this group, that they will harm the baby, and that there are insufficient study results for pregnant women affects the possibility of recommending vaccines (Bradfield et al., 2021; Castillo et al., 20221; Deruelle et al., 2021; Massot and Epaulard, 2018). There is a similar situation for students in our findings. Providing current knowledge on the efficacy and safety of vaccines in the age of fertility during the educational process will assist students in discussing these topics with their customers and recommending vaccines by alleviating their anxieties (Castillo et al., 2021).

Since the study design is cross-sectional research, it has limitations in terms of causality inference. The research sample may not reflect all students in the country due to the online unlikely sampling procedure. Since the study only included senior nursing and midwifery students, it is impossible to generalize to other students studying in different classes. Self-report surveys can result in information bias. The assessment of students' counselling competencies is based on self-evaluation, and future research should examine vaccination counselling skills under more objective situations, such as direct observation.

At the end of the study, in which we evaluated the factors related to the thoughts of nursing and midwifery senior students who are graduates in recommending the COVID-19 vaccine to women who are pregnant, breastfeeding and planning to become pregnant, it was seen that the students did not feel enough to vaccine recommendation and counselling competency to women of reproductive age. The pandemic time, during which the global scarcity of nurses is even more obvious, and some countries attempt to plug the gap with student nurses and midwifes, has once again highlighted the necessity of students' well-equipped education. Nursing and midwifery students armed with information and counselling competency in both normal and extraordinary settings can make a substantial contribution to raising societal and reproductive age women's vaccination rates. It is advised in this context to increase vaccine training prior to graduation.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Berenson, A. B., Hirth, J. M., Chang, M., et al. (2021). A brief educational intervention can improve nursing students' knowledge of the human papillomavirus vaccine and readiness to counsel. Human Vaccines & Immunotherapeutics, 17(7), 1952–1960. doi: 10.1080/21645515.2020.1852871
Bisset, K. A., & Paterson, P. (2018). Strategies for increasing uptake of vaccination in pregnancy in high-income countries: A systematic review. Vaccine, 36(20), 2751–2759. doi: 10.1016/j.vaccine.2018.04.013
Bradfield, Z., Wynter, K., Hauck, Y., et al. (2021). COVID-19 vaccination perceptions and intentions of maternity care consumers and providers in Australia. PloS One, 16(11), e0260049. doi: 10.1371/journal.pone.0260049
Burden, S., Henshall, C., & Oshikanlu, R. (2021). Harnessing the nursing contribution to COVID-19 mass vaccination programmes: Addressing hesitancy and promoting confidence. Journal of Advanced Nursing, 77(8), e16–e20. doi: 10.1111/jan.14854
Carbone, L., Di Girolamo, R., Mappa, I., et al. (2022). Worldwide beliefs among pregnant women on SARS-CoV-2 vaccine: a systematic review. European Journal of Obstetrics Gynecology and Reproductive Biology, 268, 144–164. doi: 10.1016/j.ejogrb.2021.12.003
Castillo, E., Patey, A., & MacDonald, N. (2021). Vaccination in pregnancy: Challenges and evidence-based solutions. Best Practice & Research Clinical Obstetrics & Gynaecology, 76, 83–95. doi: 10.1016/j.bpobgyn.2021.03.008
Chang, C., Hwang, G., & Gau, M. (2022). Promoting students' learning achievement and self-efficacy: A mobile chatbot approach for nursing training. Brit J Educational Tech, 53(1), 171–188. doi: 10.1111/bjet.13158
Chervenak, F. A., McCullough, L. B., Bornstein, E., et al. (2021). Professionally responsible coronavirus disease 2019 vaccination counseling of obstetrical and gynecologic patients. American Journal of Obstetrics and Gynecology, 224(5), 470–478. doi: 10.1016/j.ajog.2021.01.027
Daskalakis, G., Pergialiotis, V., Antsaklis, P., et al. (2022). Healthcare workers' attitudes about vaccination of pregnant women and those wishing to become pregnant. Journal of Perinatal Medicine, 50(3), 363–366. doi: 10.1515/jpm-2021-0536
Deruelle, P., Couffignal, C., Sibiude, J., et al. (2021). Prenatal care providers' perceptions of the SARS-Cov-2 vaccine for themselves and for pregnant women. PloS One, 16(9), e0256080. doi: 10.1371/journal.pone.0256080
Geniş, B., Gürhan, N., Koç, M., et al. (2020). Development of perception and attitude scales related with COVID-19 pandemia. Pearson Journal of Social Sciences-Humanities, 5(7), 306–328
Giles, M. L., Gunatilaka, A., Palmer, K., et al. (2021). Alignment of national COVID-19 vaccine recommendations for pregnant and lactating women. Bulletin of the World Health Organization, 99(10), 739–746. doi: 10.2471/BLT.21.286644
Goncu Ayhan, S., Oluklu, D., Atalay, A., et al. (2021). COVID-19 vaccine acceptance in pregnant women. International Journal of Gynaecology&Obstetrics 154 (2), 291–296. doi: 10.1002/ijgo.13713
International Federation of Gynecology and Obstetrics (2021). COVID-19 Vaccination for Pregnant and Breastfeeding Women FIGO Statement. Available at https://www.figo.org/covid-19-vaccination-pregnant-and-breastfeeding-women#:~:text=FIGO%2C%20therefore%2C%20considers%20that%20there,to%20pregnant%20and%20breastfeeding%20women (accessed 10 July 2022)
Januszek, S., Siwiec, N., Januszek, R., et al. (2022). Approach of Pregnant Women from Poland and the Ukraine to COVID-19 Vaccination-The Role of Medical Consultation. Vaccines, 10(2), doi: 10.3390/vaccines10020255
Jiang, N., Wei, B., Lin, H., et al. (2021). Nursing students' attitudes, knowledge and willingness of to receive the coronavirus disease vaccine: A cross-sectional study. Nurse Education in Practice, 55, 103148. doi: 10.1016/j.nepr.2021.103148
Joubert, E., Kekeh, A. C., & Amin, C. N. (2022). COVID-19 and novel mRNA vaccines in pregnancy: an updated literature review. BJOG: an International Journal of Obstetrics&Gynaecology 129 (1), 21–28. doi: 10.1111/1471-0528.16973
Krishnaswamy, S., Wallace, E. M., Buttery, J., & Giles, M. L. (2018). Strategies to implement maternal vaccination: A comparison between standing orders for midwife delivery, a hospital based maternal immunisation service and primary care. Vaccine, 36(13), 1796–1800. doi: 10.1016/j.vaccine.2017.12.080
Lutz, C. S., Carr, W., Cohn, A., & Rodriguez, L. (2018). Understanding barriers and predictors of maternal immunization: Identifying gaps through an exploratory literature review. Vaccine, 36(49), 7445–7455. doi: 10.1016/j.vaccine.2018.10.046
Manning, M. L., Gerolamo, A. M., Marino, M. A., et al. (2021). COVID-19 vaccination readiness among nurse faculty and student nurses. Nursing Outlook, 69(4), 565–573. doi: 10.1016/j.outlook.2021.01.019
Massot, E., & Epaulard, O. (2018). Midwives' perceptions of vaccines and their role as vaccinators: The emergence of a new immunization corps. Vaccine, 36(34), 5204–5209. doi: 10.1016/j.vaccine.2018.06.050
Nindrea, R. D., Djanas, D., Warsiti, D., et al. (2022). The risk factors and pregnant women's willingness toward the SARS-CoV-2 vaccination in various countries: A systematic review and meta-analysis. Clinical Epidemiology and Global Health, 14, 100982. doi: 10.1016/j.cegh.2022.100982
Oluklu, D., Goncu Ayhan, S., Menekse, B. D., et al. (2021). Factors affecting the acceptability of COVID-19 vaccine in the postpartum period. Human Vaccines & Immunotherapeutics, 17(11), 4043–4047. doi: 10.1080/21645515.2021.1972710
Patelarou, E., Galanis, P., Mechili, E. A., et al. (2021). Factors influencing nursing students' intention to accept COVID-19 vaccination: A pooled analysis of seven European countries. Nurse Education Today, 104, 105010. doi: 10.1016/j.nedt.2021.105010
Patwary, M. M., Bardhan, M., Haque, M. Z., et al. (2022). COVID-19 Vaccine Acceptance Rate and Its Factors among Healthcare Students: A Systematic Review with Meta-Analysis. Vaccines, 10(5), doi: 10.3390/vaccines10050806
Shamshirsaz, A. A., Hessami, K., Morain, S., et al. (2022). Intention to Receive COVID-19 Vaccine during Pregnancy: A Systematic Review and Meta-analysis. American Journal of Perinatology, 39(5), 492–500. doi: 10.1055/a-1674-6120
Skjefte, M., Ngirbabul, M., Akeju, O., et al. (2021). COVID-19 vaccine acceptance among pregnant women and mothers of young children: results of a survey in 16 countries. European Journal of Epidemiology, 36(2), 197–211. doi: 10.1007/s10654-021-00728-6
The International Council of Nurse (2022). The Global Nursing Workforce and the COVID-19 Pandemic. Available at https://www.icn.ch/system/files/202201/Sustain%20and%20Retain%20in%202022%20and%20Beyond-%20The%20global%20nursing%20workforce%20and%20the%20COVID-19%20pandemic.pdf (accessed 15 July 2022)
Vishram, B., Letley, L., van Jan Hoek, A., et al. (2018). Vaccination in pregnancy: Attitudes of nurses, midwives and health visitors in England. Human Vaccines & Immunotherapeutics, 14(1), 179–188. doi: 10.1080/21645515.2017.1382789
Ward, C., Megaw, L., White, S., & Bradfield, Z. (2022). COVID-19 vaccination rates in an antenatal population: A survey of women's perceptions, factors influencing vaccine uptake and potential contributors to vaccine hesitancy. The Australian & New Zealand Journal of Obstetrics & Gynaecology 2022, 1–6. doi: 10.1111/ajo.13532
World Health Organization (2022). COVID-19 advice for the public: Getting vaccinated. Available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines/advice (accessed 20 July 2022)
World Health Organization (2014). Report of the Sage Working Group on Vaccıne Hesitancy Report. Available at https://www.asset-scienceinsociety.eu/sites/default/files/sage_working_group_revised_report_vaccine_hesitancy.pdf (accessed 20 July 2022)
Yeşiltepe, A., Aslan, S., & Bulbuloglu, S. (2021). Investigation of perceived fear of COVID-19 and vaccine hesitancy in nursing students. Human Vaccines & Immunotherapeutics, 17(12), 5030–5037. doi: 10.1080/21645515.2021.2000817
Zhou, Y., Wang, Y., & Li, Z. (2021). Intention to get vaccinated against COVID-19 among nursing students: A cross-sectional survey. Nurse Education Today, 107, 105152. DOI: 10.1016/j.nedt.2021.105152

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Covid-19 Vaccine Recommendation Opinions of Nursing/midwifery Students to Women of Reproductive Age

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