- Effectiveness and safety of recommended vaccines for pregnant people. Vaccine-preventable diseases like influenza, COVID-19, and pertussis can be serious in pregnant people and young infants. I am currently leading several projects to evaluate the safety and effectiveness of recommended vaccines during pregnancy, including COVID-19 vaccines (R01AI169239) and an Australian study of influenza and pertussis vaccines (GNT1141510). By linking registry data in Western Australia, Northern Territory, and Queensland, our team plans to measure the effectiveness of seasonal influenza vaccine and pertussis vaccines in protecting mothers and babies against severe infection. My current US-based research uses insurance claims and electronic health records to similarly examine the safety and effectiveness of COVID-19 vaccination during pregnancy. I am currently working with my collaborators to extend this work to include the recently licensed and recommended RSV vaccine for pregnancy. This information is important since it can be used to improve vaccine resources for pregnant people and their providers.
- Impact of the COVID-19 pandemic on pregnant people. The COVID-19 pandemic has impacted everyone; but in particular, we know the pandemic has impacted pregnant people. Disruptions to prenatal care in response to social distancing measures have likely resulted in reduced satisfaction with prenatal care and birthing experiences. Having had my first baby in April 2020, during the first spike in cases in the US, I experienced these disruptions firsthand. This has especially motivated me to investigate how the pandemic has impacted families. Additionally, we now know that pregnant people are more likely to experience severe COVID-19 symptoms and maternal infection may pose issues for the fetus. My research aims to collect data from those who were pregnant during the pandemic to describe these experiences. Given the importance of disease prevention among pregnant people, I am also interested in collecting information on perceptions of COVID-19 vaccine.
- Improving vaccination rates in the community. When taken, vaccines offer protection and increase our chances of healthy lives. However, we know that vaccines are not always taken, and this has led me to an interest in improving vaccination rates in the community. Previously, I have led work that developed a system which physicians could use to notify at-risk patients they are eligible for free influenza vaccine. We piloted this system in doctors’ offices to see whether these reminders increase the number of individuals who get vaccinated each year. The results were modestly effective for most patient groups – with exception to pregnant people. I am particularly interested to identify evidence-based strategies that can be used to improve the uptake of recommended vaccines in pregnant people. My team is currently leading a living systematic review to identify the interventions that appear to be effective for pregnant people.
- Vaccine hesitancy & vaccine decision-making. In order to understand how to address declining vaccination rates, we need to better understand the factors driving these declines. This has led to my interest in understanding familial vaccine decision-making and developing better tools for monitoring vaccine “hesitancy,” or the refusal of vaccines despite availability. Currently, I lead a team of researchers developing a scale that can measure how “hesitant” adolescents are toward recommended vaccines (R21HD109536). We are also interested in applying this work to better understand how couples make vaccine decisions during pregnancy and early infancy. Here are some recent results from these studies if you’re interested:
- Disparities in accessing immunization. Although the benefits of vaccination have been well documented, not everyone has access to vaccines. While racial/ethnic disparities have been recently documented for immunization rates among pregnant people, I am particularly interested in place-based disparities. Our recent research has shown that individuals are less likely to receive an influenza vaccine during pregnancy if they reside in a rural area of the US. In collaboration with other members of the Southwest Rural Health Research Center, we recently evaluated the importance of state policies and access to health insurance in relation to this gap – and we are currently working to extend this work to evaluating place-based disparities in childhood immunizations.
Annette Regan 
