Psychological distress, vaccine, and booster acceptance in women considering or undergoing fertility treatments during the Omicron surge of the COVID-19 pandemic

Luce A Kassi; Angela K Lawson; Eve C Feinberg; Amelia Swanson; Shriya Shah; Mary Ellen Pavone

doi:10.1007/s10815-024-03075-z

Psychological distress, vaccine, and booster acceptance in women considering or undergoing fertility treatments during the Omicron surge of the COVID-19 pandemic

J Assist Reprod Genet. 2024 Mar 9. doi: 10.1007/s10815-024-03075-z. Online ahead of print.

Authors

Luce A Kassi¹, Angela K Lawson², Eve C Feinberg², Amelia Swanson², Shriya Shah², Mary Ellen Pavone³

Affiliations

¹ Brown University, 222 Richmond Street, Providence, RI, 02903, USA.
² Department of Obstetrics and Gynecology, Northwestern University, 676 N Saint Clair, Suite 2310, 250 E. Superior Street, Chicago, IL, USA.
³ Department of Obstetrics and Gynecology, Northwestern University, 676 N Saint Clair, Suite 2310, 250 E. Superior Street, Chicago, IL, USA. m-pavone@northwestern.edu.

PMID: 38460086
DOI: 10.1007/s10815-024-03075-z

Abstract

Objective: Follow-up study to evaluate perceptions of COVID-19 vaccination and booster with psychological distress during the COVID-19 pandemic and Omicron surge in women considering or undergoing fertility treatment.

Materials and methods: Cross-sectional anonymous survey (N = 2558) from a single academic fertility center. Five hundred forty patients completed the survey (response rate = 21.1%). Participants were randomized 1:1 to a one-page evidence-based graphic with information and benefits regarding COVID-19 vaccination. Mental health and vaccine hesitancy were assessed via the Patient Health Questionnaire Depression (PHQ-8), the Generalized Anxiety Disorder (GAD-7) scales, and the Medical Mistrust Index (MMI).

Results: Majority of participants were nulliparous, fully vaccinated with a booster dose, with > 1 year of infertility and mild to moderate distress. Patients with vaccine hesitancy had higher medical mistrust scores (r = .21, p < .001). Higher MMI scores were not associated with vaccination during pregnancy. Participants that had higher PHQ-8 and GAD-7 scores were more likely to believe the omicron variant would cause delay in fertility treatments, would have impact on fertility outcome, and were more likely exhibiting medical system distrust (p < .001). Participants who received educational material were more likely to know pregnant women with COVID-19 had increased risk of death, stillbirth, and preterm birth (p < .05).

Conclusion: The majority of women in this study were vaccinated and had received their booster dose but also with clinically significant levels of depression. Patients with higher levels of distress and greatest medical mistrust demonstrated a concern that the Omicron variant would delay treatment, lead to suboptimal fertility outcomes, and COVID-19 vaccination would impact risk of miscarriages.

Keywords: COVID-19; Coronavirus; Fertility; Omicron pregnancy; Vaccine hesitancy.