Ep.16/ Maternal Vaccines and Disparities with Vaccines Among Pregnant Women with Dr. Annette Regan
EP.16/ Maternal Vaccines and Disparities with Vaccines Among Pregnant Women with Dr. Annette Regan
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Note: This transcription has been created with a help of an AI thus errors and mistranscriptions may be present.
[00:00:00] Dr. Anetta Regan: Hello? Maternal Health 911? What's your emergency?
[00:00:14] Dr. Jill Baker: Hi, I'm Dr. Joe Baker. I'm a wife, a mother, a community health scholar, an executive director, and a fertility coach. More than 12 years ago, I was on my own infertility journey. Since then I've made it my personal mission to help anyone who is on their own journey. to become a parent as well as shed light on infertility and maternal health experiences of BIPOC women and couples.
[00:00:42] Dr. Jill Baker: Now let's begin this week's episode of Maternal Health 9 1 1.
[00:00:56] Dr. Jill Baker: Hello listeners. Welcome to this very special episode of Maternal Health 9 1 1. Today we will be talking about maternal vaccines. And disparities with vaccines among pregnant women. And I'm very blessed to have today, my very dear friend and colleague, the brilliant and amazing Dr.
[00:01:22] Dr. Jill Baker: Annette Reagan. Dr. Reagan is a perinatal and pediatric infectious disease epidemiologist with over 16 years of experience in leading epidemiological research and public health practice. She completed an MPH in Epidemiology at the Rollins School of Public Health, Emory University. In 2006, in georgia and a phd in infectious diseases at the university of western australia in 2016 She has previously worked as an epidemiologist for state and federal public health agencies Including the u.
[00:02:01] Dr. Jill Baker: s centers for disease control and prevention cbc for
[00:02:05] Dr. Anetta Regan: short Something else we have in common,
[00:02:07] because
[00:02:08] Dr. Jill Baker: I worked on a CDC project too. I don't think we knew that. But during Dr. Reagan's time at CDC, she coordinated national surveillance activities and had the opportunity to serve in emergency response operations.
[00:02:23] Dr. Jill Baker: Including the response to the 2009 Influenza AH1N1 pandemic. Oh my gosh, that was such a crazy, that was a crazy time. That was a crazy time in public health. But we'll talk, we can talk more about that later. I'm just getting a flashback. So after Dr. Reagan left the CDC in 2011, She spent seven years living in Australia.
[00:02:46] Dr. Jill Baker: Oh my gosh, I'm jealous. Working for the state health department in Western Australia. And during her time there, she implemented several communicable disease prevention and surveillance programs, including the development of novel SMS based surveillance tools for monitoring vaccine safety during pregnancy and emerging infectious disease threats, such as the Ebola virus.
[00:03:11] Dr. Jill Baker: Since returning to the U. S. in 2018, she has been a faculty at the Texas A& M University School of Public Health, where she lectured on epidemiologic methods, infectious disease epidemiology, and reproductive health, and served as the Deputy Director of the Maternal and Child Health Program. She is currently a tenure track faculty at the University of San Francisco in the School of Nursing and Health Professions.
[00:03:40] Dr. Jill Baker: Her research program aims to support and promote maternal and child health, including topics of which we're going to talk about today. Maternal vaccines given specifically during pregnancy, perinatal infection, birth spacing. And vaping and tobacco use during pregnancy. She currently serves as a PI on several NIH awards to evaluate the uptake safety and effectiveness of COVID 19 vaccines during pregnancy and to identify and address barriers to adolescent COVID 19 vaccination.
[00:04:15] Dr. Jill Baker: Her research has been, yes, listen to this published in over 100 peer reviewed papers. In journals, such as the Lancet Global Health, Lancet Infectious Diseases, JAMA, BMJ, American Journal of Epidemiology and Obstetric Journals. So people, for those of you who are not, in academia, all I have, the translation is these are all big time journals.
[00:04:42] Dr. Jill Baker: And I'm like, how did you do this? Just so like in awe, in addition to her research and teaching Annette serves on several global committees to improve global vaccine safety surveillance With a special focus on vaccines and minister during pregnancy. And lastly, in her personal life, she spent as much time as possible swimming.
[00:05:05] Dr. Jill Baker: Oh yeah. Hiking and nature walking with her husband and her two year old son, who is a pandemic baby to lots of those. Not here, but lots of us, everyone. Without further ado, everyone, let's welcome Dr. Reagan to the show, to Maternal Health 901.
[00:05:27] Dr. Jill Baker: Thank you. Hi, it's nice
[00:05:28] Dr. Anetta Regan: to be here. I'm blushing with such a nice intro.
[00:05:31] Dr. Jill Baker: Were you at the CDC when you worked there?
[00:05:34] Dr. Anetta Regan: Yeah, so I It was my first job post MPH post graduation. I don't know how I got so lucky. But yeah, I was, I started off as a contractor and then moved into a full time position with them as a epidemiologist in the office of smoking and health.
[00:05:51] Dr. Anetta Regan: So that was a really, and then for some reason I left. I don't know why. How
[00:05:57] Dr. Jill Baker: long were you there in total? Five
[00:06:00] Dr. Anetta Regan: years. I was at CDC for five years.
[00:06:02] Dr. Jill Baker: Wow. Wow. I, so I worked on a project with the CDC. I worked on the dissemination of the sister to sister intervention, which is the HIV intervention prevention That's Dr.
[00:06:15] Dr. Jill Baker: Loretta Jamaat. Shout out to Dr. Loretta Jamaat. So we did We had to go to the CDC to have meetings with the project officers. We're very involved. So I've been at the seat, the building, awesome building, a big building. It is.
[00:06:33] Dr. Anetta Regan: It's just a pain to get into, right? I know.
[00:06:36] Dr. Jill Baker: I couldn't believe all the stuff that we had to go through security wise.
[00:06:40] Dr. Jill Baker: Security is important. Yeah. To get in the bill. I was surprised about that. I was like, Oh,
[00:06:45] Dr. Anetta Regan: okay. Chambly campus. Which I don't think exists anymore, but Oh wow. We were right next to fema, so it was like super security .
[00:06:55] Dr. Jill Baker: Dang. Yeah, that makes sense. Yeah. Yeah, that does make sense. All right, so you were in, okay, so you were in Georgia.
[00:07:03] Dr. Jill Baker: Okay, so Australia. Okay, so you have to tell me where were you in Australia when you were in school? Yeah,
[00:07:10] Dr. Anetta Regan: so I met my husband in Atlanta, and then we decided oof, let's like, Let's just move somewhere fun. And we ended up in Perth, which is, yeah, the capital of Western Australia. My husband's in oil and gas.
[00:07:23] Dr. Anetta Regan: And there was there's a lot of, there were a lot of oil and gas opportunities there. So he had a job he liked and I landed with the department of health there in Western Australia. And it was a great, I miss Australia almost every day. It's a wonderful place. Beautiful people.
[00:07:39] Dr. Anetta Regan: Beautiful ocean, beautiful land. So
[00:07:41] Dr. Jill Baker: I was able to go to Australia when my kids the twins were four. So let's say they're going to be 12. So it's eight years ago. And it was for an HIV, it was like a big HIV conference. So I got to be there for a week, but I was in Melbourne. I was in Melbourne for a week.
[00:08:00] Dr. Jill Baker: Yeah. But yeah,
[00:08:01] Dr. Anetta Regan: Melbourne's really nice. Great coffee. But
[00:08:05] Dr. Jill Baker: I loved
[00:08:05] Dr. Anetta Regan: it. I loved it. Hold on a minute. Hold on a minute. You took two four year olds on a plane to Australia? No.
[00:08:10] Dr. Jill Baker: They did not go.
[00:08:12] Dr. Anetta Regan: I
[00:08:12] Dr. Jill Baker: was by myself. Oh, yeah. No . I was gonna say, I'm about to give you an award.
[00:08:20] Dr. Anetta Regan: Oh yeah. No, . I can't even get my he turned three last weekend and I have a three year old now.
[00:08:26] Dr. Anetta Regan: Oh my God. But I can't even get him to the east coast of the United States, let alone to another continent. Oh yeah. No. So
[00:08:32] Dr. Jill Baker: I gonna say, my husband, let me go. Aw. I was like, I, when am I gonna get a chance to go to Australia? And did you love it? Loved it. Yeah, the people were just amazing. The food was amazing.
[00:08:46] Dr. Jill Baker: It's clean. It's an awesome spot. Yeah.
[00:08:49] Dr. Anetta Regan: Yeah, and and I think professionally, it's also there's some really great, like they have some fantastic public health and great surveillance systems. There's a lot of people that just really quickly roll up their sleeves to make things happen. And in public health emergencies, scratch things together like incredibly quickly.
[00:09:08] Dr. Anetta Regan: Yeah, absolutely. It's a great place to work in public health as well.
[00:09:12] Dr. Jill Baker: Yeah, I was very impressed. They had a lot of we took the train and the bus. And there were advertise, advertisements everywhere. I was like, Oh, wow, that's different. There were like condom promotion. The trend.
[00:09:27] Dr. Jill Baker: Yeah. Very progressive. I was like,
[00:09:29] Dr. Anetta Regan: okay. I was, I worked, so I was in the communicable disease. Section, which you would think encompass, it yeah, we worked, I was mostly with vaccine. And I worked right next door to the sexual health unit and I was always super impressed with their campaigns, like really pushing the envelope, like things that I don't think you would see in the U.
[00:09:49] Dr. Anetta Regan: S., you would have public outcry with how, but they were what, they were fantastic. They really feel like spoke to younger. The, the target audience that you really want to hit, right? For HIV prevention and HIV and STDs. Exactly.
[00:10:05] Dr. Jill Baker: Absolutely. So that's okay. So you got to live, I would definitely live there.
[00:10:09] Dr. Jill Baker: I loved it. So
[00:10:11] Dr. Anetta Regan: I get it. Highly recommend, but really hard if you want to bring the kids back and forth, like young kids back and forth to visit grandparents. Cause that's a brutal trip. That was a 24 hour flight from
[00:10:25] Dr. Jill Baker: DC, from LA, had to fly from Philly to LA, Melbourne,
[00:10:29] Dr. Anetta Regan: 24 hours. Yeah. Now imagine if you lived in Perth and after you get to Melbourne, you're not done yet.
[00:10:35] Dr. Anetta Regan: You got another five hour flight to Perth. Oh
[00:10:38] Dr. Jill Baker: wow. Okay. That's good. Oh wow. Okay. That's good.
[00:10:43] Dr. Anetta Regan: Yeah. Yeah. So we miss it. But, now that we have a family and everything it's nice being back in the U. S. and being a little closer to family and... Tackling public health problems here as there are many,
[00:10:57] Dr. Jill Baker: unfortunately we're never out of we wouldn't have, careers or,
[00:11:02] Dr. Anetta Regan: I'd love to retire early.
[00:11:06] Dr. Anetta Regan: My neighbor's 45 and he's talking about retiring and I'm like, how do I would love for the world to be just, everybody's happy, healthy, and we can.
[00:11:14] Dr. Jill Baker: That's my husband's dream. I know. Retiring at 45. Gonna be 50 now. I'm like, I don't know. Maybe for you. No. No. Yeah. There's still too much to do.
[00:11:25] Dr. Jill Baker: There is. Yeah. Yeah. So speaking of, how did you decide specifically that you wanted to be an epidemiologist and focus on vaccine safety, vaccine education and particularly for for perinatal a perinatal focus with your work. Was it something personal or something you were exposed to and.
[00:11:57] Dr. Jill Baker: You were good at it or you saw a gap for, more work in that specific area.
[00:12:03] Dr. Anetta Regan: Yeah. I think how I came to where I am is really just following the things that you're passionate about, which is something I always, when I'm giving advice to early career folks or some of my students, I think that's really the best way to find your path, follow what you're really passionate about.
[00:12:21] Dr. Anetta Regan: And I came to. The combination of vaccines and pregnancy, a little bit by accident, but I feel like it was serendipity, it was fate. I fell into epidemiology. I was pre med in undergrad and realized. Huh.
[00:12:37] Dr. Jill Baker: No, I have, my best friend was pre med in college, changed her mind. And then went into public health and that's how I learned about public health because she ended up getting her MPH and I was like, what is that?
[00:12:52] Dr. Jill Baker: I never even heard of public
[00:12:53] Dr. Anetta Regan: health. Same, I was pre med and then I was like, I just don't think I'm ready for this. Cute, to and I really struggled with organic chemistry. Organic chemistry. That
[00:13:04] Dr. Jill Baker: kills the pre med.
[00:13:07] Dr. Anetta Regan: It did awesome and everything else, but anyway, so I was like, okay, what am I going to do?
[00:13:11] Dr. Anetta Regan: I think maybe I'll I heard about this MPH degree and I got some advice from our pre med student association that, yeah, that might be a good idea to see, how you go and then you can always apply to med school after if you're still interested. And when I started specifically looking at different fields and I read about epidemiology, I was like, Oh, you mean like outbreak?
[00:13:31] Dr. Anetta Regan: And cause contagion didn't exist at the time, but like these sort of, wow, like that sounds great. And then you mentioned we're geeks. I am a total data geek. I love, I actually took math classes in my undergrad for fun. Oh, I took differential equations. For fun. I'm, I used to be embarrassed of that. Now I'm semi proud, but I really love math and I always knew I was pre med.
[00:13:55] Dr. Anetta Regan: I always knew I wanted to help people. I wanted to make people help people be healthy. And when I read about this epidemiology field where I was like, wait, you get to combine math with health. This sounds awesome. Plus, hot zone and all those really amazing things. So I signed up and seriously, my whole two years at Emory, I, there was not one class I hated. I love, I knew that I was in the right place. I loved everything that I studied. I was really passionate about everything that we were learning. So I knew I was in the right place. And then when I finished and I managed to work at CDC, I was like, this is great.
[00:14:29] Dr. Anetta Regan: And I always had an interest in maternal child health. It's always been an area that I just think is really important and. And I can't really link it to, an event or anything. I just, it's been at my core, I think always. So when I did my MPH, my advisor was Dr. Cale Hogue, who is one of the greats in reproductive health.
[00:14:48] Dr. Anetta Regan: And I got to do some research on contraceptive use. So I always knew I wanted to do maternal child health. My first job wasn't smoking, so I got to do a little bit of tobacco use and pregnancy and things like that. And then the pandemic, our last pandemic hit in 2009. And immediately they were like, we need help.
[00:15:07] Dr. Anetta Regan: This is a lot. And I was at CDC, so I was able to volunteer for the Emergency Operations Center. So I got to help the epidemiology response team do cases. Tracing and managing all the case data that was coming in and that was really cool. I, it really sparked something in me like, yeah, I love what I'm doing.
[00:15:30] Dr. Anetta Regan: I love, I, I could do, I could work in a variety of things in public health, but just, I don't know. It was just so exciting. And the fact that infectious diseases are things that. We can't prevent all of them, but there are a huge chunk of infectious diseases that we have the ability to prevent through immunization.
[00:15:47] Dr. Anetta Regan: We do. So it just sparked something in me. I knew I wanted to sidestep into infectious diseases. So that was around the time we moved to Australia. I started doing a University of Western Australia has a very cool program that I don't know many other parts of the world that have them.
[00:16:02] Dr. Anetta Regan: So they actually do. A masters of infectious diseases where you get to learn like the whole spectrum. Yeah, it was a very cool, I was so excited to get into that program. So you learn I learned how to do a PCR. I learned how to do essays. So I know, don't ask me to do it. Nobody would hire me to do bench work now, but I, yeah, I learned like the, the hard way of how to do PCRs and tagging, how to work in a hood, how to like, so that was really cool. But then you also get to learn the Epi, which I was a lot more comfortable with. So I it really opened up, my understanding of infectious, all the different disciplines that you need for infectious disease work. And then I went, I carried on into my PhD and I got to work with the department of health and.
[00:16:50] Dr. Anetta Regan: I'm interested. So this is why I feel like maybe it's all serendipitous or fate or whatever you want to call it, because I actually really wanted to get into Murray Valley encephalitis, which is a very uncommon, but very severe mosquito borne disease. I was fascinated by it for some reason, but there's five cases in all of Western Australia per year.
[00:17:10] Dr. Anetta Regan: And my supervisor, Dr. Paul Effler, who has, he's an amazing mentor, fantastic global public health expert and epidemiologist has done some crazy field work and now works a lot for WHO and go on. So anyways, I sat down with him. I knew I wanted to do my PhD with him and he's he makes fun of me now.
[00:17:31] Dr. Anetta Regan: He's yeah, I don't know, how much work you'd be doing now on Murray Valley encephalitis epi. But he said, so I don't think that's a viable PhD, but I really want somebody to evaluate our Or influence a vaccine program for pregnant. People and I was Oh, okay.
[00:17:47] Dr. Anetta Regan: Yeah, that sounds. Yeah. Like I've had my interest sparked on influenza. I really want to work in vaccines and it was bringing me back to that maternal child health. And then here we are. Today, 16 years later I got to do a lot of really fun work in Western Australia doing, I did some linkage of their datasets to generate some data, looking at the safety and the effectiveness of flu vaccine and pregnancy, and then I also got to set up, you mentioned in my bio, I got to set up.
[00:18:19] Dr. Anetta Regan: So this was before we had be safe and all these things that now we like, this was back in 2012. 11 years ago, back before SMS really took off or text messaging really took off and develop. I don't want to say the first, cause I'm sure somebody else did. I think I think Melissa Stockwell had already done work in the U S but it was the first in Australia.
[00:18:41] Dr. Anetta Regan: It was the first in Australia. The first SMS based system to follow up pregnant people who've been recently immunized, and it was really a very cool experience that we were following people up within 36 hours of getting their vaccine or within a week with after getting their vaccine.
[00:18:59] Dr. Anetta Regan: And then asking them collecting information on any reactions they may have had. But what was really cool about it was how fast these systems can move because we were able to feed this information back to the, to healthcare providers and to the public, like in real time. So within the first few weeks of we actually worked it out within a month of rolling out flu vaccines, we could actually say, this is.
[00:19:20] Dr. Anetta Regan: These are this is your chances of having a reaction. We haven't detected anything no severe adverse events, and that was really important, I think, for supporting vaccine confidence early in the seasonal vaccine rollout.
[00:19:34] Dr. Jill Baker: Yeah. And that was, yeah, everyone's doing text now, but that wasn't the case
[00:19:41] Dr. Anetta Regan: at that time.
[00:19:43] Dr. Anetta Regan: Yes, I think it's nice to see how those systems have really developed. So now there's a national system in Australia, and we saw, V safe was, I think, a big, a huge success here in the U. S. for being able to follow up COVID vaccines in real time. So I think, yeah, it's old news now, but yeah, in 2012 it was.
[00:20:02] Dr. Anetta Regan: It was not easy. It was a lot. It was a lot of men, like literally at some point, like things wouldn't work and you'd have to manually text people. So we definitely did not have, the highest tech at that time. I'm sure the systems are, seamless now,
[00:20:18] Dr. Jill Baker: but right. Oh my gosh. I love it.
[00:20:21] Dr. Jill Baker: I love it. And I've had the chance to, work on a vaccine studies as well and the HPV vaccine and when the vaccine first came out and and that was tough because no one was really, no one was really studying the HPV vaccine and you're working with Yeah, girls of color and their parents and educating the parents about why the vaccine was important, but that was right when the vaccine came out and then talking to people about, what their concerns were about vaccine.
[00:20:58] Dr. Anetta Regan: And still super important today. HPV vaccine. We need, we still need more work there.
[00:21:05] Dr. Jill Baker: Yeah. I can tell, I'm sure, one of the it was interesting. We had a program that was in Philly and that was mostly African American black girls and their parents. And then we had a rural partner.
[00:21:19] Dr. Jill Baker: I won't say the name, but it was somewhere in Pennsylvania. And it was a mostly, white parents, white. And they didn't want to have our program that we developed the intervention that we developed, which actually was effective in getting a significant amount of the girls to complete the vaccine.
[00:21:40] Dr. Jill Baker: And that was from data. Because we tracked them through the registry at CHOP, Children's Hospital of Philadelphia. So we were able to get actual numbers of who was getting the vaccine. So it wasn't self report data. But this other yeah organization, they said, these parents said that, their children didn't have sex.
[00:22:03] Dr. Jill Baker: And if we push the program about the HPV vaccine, then we would be pushing their kids to then want to have sex. So they said we can take information about the vaccine by itself, but we don't want anything related to using condoms in addition to the HPV vaccine. So we really had to water down the program itself because these parents, these particular parents felt like.
[00:22:34] Dr. Jill Baker: It will be encouraging their teens to have sex. Wow. That's really what like 20, 2000, 2009,
[00:22:47] Dr. Anetta Regan: maybe a really disappointing. Cause it, and it, I think it speaks to the misperceptions and myths of vaccines, cause that's a really common myth about that, which
[00:22:57] Dr. Jill Baker: I wanted us, so maybe this, I wanted us to talk about that anyway. So maybe this is a good. Yeah, good segue. And you're the real expert in this area.
[00:23:07] Dr. Jill Baker: From your work. Yeah. What do you feel are the main kind of the main barriers? I think one for vaccines, period. But then when we think about pregnant women, specifically what are some of the
[00:23:20] Dr. Anetta Regan: main myths? Yeah, so it's a really interesting space. I think I'll start with I think pregnancy is not a time that until much more recently we've viewed as a time where you'd be getting vaccines.
[00:23:33] Dr. Anetta Regan: So we know what really was a game changer was that last pandemic in 2009. It's it's eerie how we see it repeated with COVID, but it's not that surprising because we know when you're pregnant, your immune system. Functions a bit differently. Your you respond really well to vaccines, but your response to viruses and things like that can be really suppressed because your body is dealing with a lot and you have a growing, the growing baby and everything.
[00:24:00] Dr. Anetta Regan: So there's a lot going on. And we know that pregnant individuals. Do tend to get more sick respiratory virus. Yes, and we definitely saw that in the last pandemic in 2009 so even though they make up a small percentage of the population, I think at the end of the day they showed pregnant individuals made up five percent of all deaths during the h1n1 pandemic and they were much more likely to be hospitalized same thing that we're seeing now with COVID, unfortunately.
[00:24:33] Dr. Anetta Regan: And then, so we definitely want to protect pregnant People during, against these respite, these severe respiratory infections. So that covers flu that covers COVID. But there's another reason why we want to give the vaccine during pregnancy. And that's because pregnancy is so cool.
[00:24:49] Dr. Anetta Regan: So you're actually passing positive things to the baby during pregnancy. So antibodies are actually going to cross the placenta to the baby. And this is such an awesome process that the baby actually has more antibodies than you by the time the baby's born. So they have all these antibodies in them that they're getting.
[00:25:09] Dr. Anetta Regan: So you get the vaccine, you produce the antibodies, they cross the placenta to the baby, and then the baby's born with protection immediately from day one, those antibodies, unfortunately don't stick around forever, but they'll, we have good data to show that they stick around long enough so that by the time the baby's old enough to get their first vaccines, they're protected against.
[00:25:30] Dr. Anetta Regan: against these particular diseases. So that covers fluent COVID. But that's the reason why we really give Tdap or pertussis vaccine, because you create antibodies in your late second trimester, early third trimester, pass it to the baby, and then baby's protected against whooping cough until they get their first vaccines.
[00:25:52] Dr. Anetta Regan: Two months of age, and I think we're gonna see an R S V vaccine as well to keep babies from getting Yeah, I think that might happen. My, my
[00:26:02] Dr. Jill Baker: son Gavin got r SV when, Aw, he was six months since, yeah. Daycare, I'm pretty sure he got it from daycare. And, but he ended up being at my current job, children's Hospital, Philadelphia, for a week.
[00:26:15] Dr. Jill Baker: And they took treated, they took, they just took such great care of him, but it was so scary. It was so scary.
[00:26:22] Dr. Anetta Regan: Yeah, I it's like it was one of my when we had the really bad R. S. B. outbreak here in Orange County. It was one of my like worst fears. So all almost all Children get R. S. B. By the time they're two years old.
[00:26:33] Dr. Anetta Regan: Yeah, at some point, right? Yeah. Yeah. But young Children are just more likely to get You know to end up in hospital and we want to keep that from happening and yes Yeah, this is what i'm saying vaccines This is why I love working in this space like we can actually keep babies from going to hospital and in the case of whipping cough where You know It's so severe that the baby could die.
[00:26:56] Dr. Anetta Regan: Like we could actually keep children from dying at a really young age. So that's why we give the vaccines, but I think we didn't really see a lot of, and we're starting to see more vaccines come out. So I mentioned, I think we're going to have an RSV, the clinical trial data look good, FDA is going to discuss it and it's on the.
[00:27:12] Dr. Anetta Regan: board for the advisory committee of immunization practice to discuss, whether or not they'll recommend it. So it looks like there's going to be an RSV vaccine that'd be given in pregnancy, but we'll see, it's not decided yet. So we have all these vaccines coming out, but this isn't something that we have.
[00:27:30] Dr. Anetta Regan: I wouldn't say until that last pandemic in 2009, where, people were very scared of all these stories about pregnant people in hospital dying with H1N1 or swine flu, and people were scared and it did result in a large increase in vaccination. So I know in Australia. We went from vaccinating something between five and 9 percent to vaccinating not, it didn't go up like a huge amount, but 30, 30 to 35%.
[00:28:00] Dr. Anetta Regan: That's a big jump for within a year. Yeah, and since the pandemic, we have seen these slow increases and it's becoming more and more. People are more and more aware, I think, that they need to get the flu vaccine while they're pregnant. So we do continue to see these increases. But so I think there's a little bit of wow, I didn't know that's something that we do.
[00:28:21] Dr. Anetta Regan: And I know we actually did try some interventions in Australia, and that was some of the feedback that we got. We would send them reminders to get vaccinated, and the pregnant participants would tell us, oh, I thought that was a mistake. Like surely you're not telling me that I should get a vaccine while I'm pregnant.
[00:28:38] Dr. Anetta Regan: But I think that's changing. I think, the awareness that we should, that there are vaccines that we should get while we're pregnant is increasing. But there's also pregnancy is also this really intense time. Like you get told a lot, don't drink medic. I
[00:28:56] Dr. Anetta Regan: found an article on the dying hair and I was like, what really, let me tell you
[00:29:00] Dr. Jill Baker: something. The first pregnancy I listened to that second. I was like, I'm getting my hair cut And that's why I look so much better post delivery with my youngest with amari because I had just got my hair colored Two weeks prior, I it didn't matter.
[00:29:23] Dr. Anetta Regan: I'm sorry. I'm not sure about the
[00:29:25] Dr. Jill Baker: evidence on that. Now, I have gray hair. I have to get my hair cut.
[00:29:30] Dr. Anetta Regan: I had my hair done when I was pregnant. And I didn't feel bad about it. No.
[00:29:34] Dr. Jill Baker: The first, your first one, you listened to, and I, me as twin, so I listened to almost everything.
[00:29:40] Dr. Jill Baker: Of course. Everything that you weren't supposed to
[00:29:44] Dr. Anetta Regan: do. Yeah. There's you get so much information, do this, don't do that, and I think, yeah, don't take don't take certain pain relievers, you can't take all these things that are a normal, sorry, I don't want to say normal outside of pregnancy.
[00:30:01] Dr. Anetta Regan: I think
[00:30:01] Dr. Jill Baker: When I was pregnant with Amari, I got something about, somebody sent me something about not taking Tylenol because since he was a boy. I don't remember what it was, but something was more likely to happen to him if I took Tylenol while I was pregnant with him. So I didn't
[00:30:17] Dr. Anetta Regan: take Tylenol.
[00:30:18] Dr. Anetta Regan: Yeah. There's studies looking at acetaminophen use and yeah. And birth outcomes. I still think it's there's still some question marks, but right. Yeah. It's a hard space. I will say that. And I'm a public health doctor
[00:30:29] Dr. Jill Baker: and you too. It's so for us, it's okay, if we're saying like, this is a lot.
[00:30:35] Dr. Anetta Regan: But no, and I feel like you get a lot of conflicting advice as well. So I remember I actually ended up back in hospital two days after I had Cameron and they had to give me I think it was hydrocodone and I was like, but I'm breastfeeding. So isn't that bad? And then the pediatrician would say, don't breastfeed because you don't want to give the baby hydrocodone.
[00:30:56] Dr. Anetta Regan: And then, but then the the lactation consultant and the OB was like, Oh no, you can totally breastfeed while you're on hydrocodone. So I'm like, I have two different health professionals that are telling me different things. It's very, it can be, I think it can be very confusing because you get conflicting advice.
[00:31:13] Dr. Anetta Regan: And
[00:31:13] Dr. Jill Baker: they're not talking to each other and you're in the middle and
[00:31:18] Dr. Anetta Regan: yes. And I think yeah, the, I, this is only a personal Experience, but I feel like the advice you get from pediatricians is very different to the advice you get from somebody that's a maternal health provider, because they are coming at it from different angles.
[00:31:31] Dr. Anetta Regan: One's very focused on the pediatric patient and one's very focused on, on you as the maternal mother. Yeah. So I feel like it can be a very confusing space. We get that feedback a lot. I'm just not sure I haven't. I don't know, especially with COVID, that was a problem. I just don't know. I don't know enough about the vaccine.
[00:31:53] Dr. Anetta Regan: We don't have enough experience. I don't feel comfortable taking the vaccine, which I think is a completely valid concern. We didn't. So this has been a longstanding problem for vaccines and pregnancy that we tend to say pregnant people are a vulnerable group. We don't want to include them in these clinical trials.
[00:32:13] Dr. Anetta Regan: We don't want to, experimental vaccines, but what ends up happening, it's like a double edged sword. What ends up happening is then you got a vaccine, you have a group that, really having these severe adverse. outcomes after getting COVID and you have no data to support the, no clinical trial data to support safety.
[00:32:34] Dr. Anetta Regan: And you're asking people to take it based on, we don't believe there's going to be any harm and right. And there, there doesn't, there wasn't, but still that's a pretty big leap, I think that you're asking people to take. And I know for healthcare professionals, that was.
[00:32:49] Dr. Anetta Regan: Unfortunately, a lot of that got put on them. So I think that's really unfortunate and something that is going to change. I think it should have changed from the 2009 pandemic. Cause we were in the same boat, they needed to take a pandemic vaccine. And but at least we had a lot of experience, the flu vaccine.
[00:33:06] Dr. Anetta Regan: This is COVID is a new vaccine. So I'm hoping that's going to change that we do, Pfizer and some other manufacturers that plan. Some vaccine trials, but they were too late, you know These trials take a very long time to do like with the rsb trial. Oh my goodness. Like I would some of my friends are Site and leads for that trial and just listening to their experience with recruiting people for that trial They take a long time to do and I think in emergency settings.
[00:33:37] Dr. Anetta Regan: It's really hard, but i'm hoping we can I don't know, come together and figure out how to get that clinical trial data in a timely way so that we have early evidence for people who are pregnant and need that data to make decisions. But getting to your like myths and why so that's part of it.
[00:33:56] Dr. Anetta Regan: We, when we, I've done, we've done a lot of work talking to people about various, Tdap, flu, COVID. Yes. It's pretty consistent, if you're worried about if the vaccine's not safe. You're much more likely to not get it. I think that's common sense. Yeah. But what I think is interesting is it seems to be way more about the baby than the mothers.
[00:34:17] Dr. Anetta Regan: You're not so worried about you getting sick or you having a reaction. You're worried about. Anything happening to the baby. And I think one thing that we I had actually I can't remember the expert that I was speaking to about this, but they made such a great point. I don't think we do a good enough job explaining what actually happens in pregnancy when you get the vaccine.
[00:34:36] Dr. Anetta Regan: So I mentioned like the antibodies cross. But nothing in the vaccine actually crossed. So like you're getting that vaccine and all the things that are in the vaccine, the things to keep it from preserving it, the antigen, none of that crosses the placenta, it's just those antibodies that are good for the baby, the vaccine's not actually crossing.
[00:34:56] Dr. Anetta Regan: And I don't think we communicate that very well to people. So of course you're going to be concerned but I'm taking a medication, and is that going to harm the baby? So there's that. I think having the understanding that the vaccine is going to, so again, don't seem to care if the vaccine is going to protect them, but when you tell people it's going to protect the baby, that's, a major selling point.
[00:35:19] Dr. Anetta Regan: So in a previous study that we did, yeah, 93 percent of people who said they got the vaccine while they were pregnant, 93%.
[00:35:35] Dr. Anetta Regan: 93%, almost a hundred percent got it because they wanted to protect the baby. And this was flu. And then I think the biggest and most consistent factor that we identify is that healthcare providers are not always recommending it. So we found that when a provider, when your provider recommends it, you are as much as 12 times more likely to get the vaccine,
[00:35:58] Dr. Jill Baker: 12 times more likely to get it back.
[00:36:01] Dr. Jill Baker: If your health care provider recommends it that's key.
[00:36:07] Dr. Anetta Regan: Yeah. I know that's a space that we are, that people are doing a lot of work on.
[00:36:11] Dr. Jill Baker: That makes sense because I can tell you that when we created the intervention program for the HPV vaccine, again, nine one of the things we asked when we did focus groups and we asked the teens separately and we asked the parents separately.
[00:36:29] Dr. Jill Baker: Who's opinion matters about you getting this vaccine, the HPV vaccine? Both said, the teens said in their own groups, my doctor. The parents said the pediatrician. And so these are two separate groups saying the same thing. And so what we ended up doing was putting a healthcare provider communication module in the intervention for the teens and for the parents.
[00:36:59] Dr. Jill Baker: So they could learn how to communicate with their doctor about the vaccine. So people think, I'm like, and these teens, they said my, what my doctor says matters. And these were well, two, two, two 16
[00:37:15] Dr. Anetta Regan: year olds. Yeah. Yeah, I think having that voice and advice and a conversation about the vaccine is really important.
[00:37:26] Dr. Anetta Regan: And I think in the case of pregnancy, it can really depend on where you're getting your care. So I can share one of my own stories as well. So as a vaccine person, I was pretty annoyed at my OB and I had a primary care provider and an OB I was seeing in Texas where I started my pregnancy. Not one person talked to me about vaccination.
[00:37:50] Dr. Anetta Regan: Not one. Multiple health providers that couldn't mention it to me. And I made, okay, so I had to go to my pharmacy. You can also get your vaccine from a pharmacy, which is great in the U, in the U. S. I went to my pharmacist and I said I'm in my first trimester. I'd really like my flu vaccine because it's You know, flu season's about to hit.
[00:38:07] Dr. Anetta Regan: My pharmacist was over the moon and said, I love vaccinating pregnant people. So she gave me my vaccine and then I made sure the next time I went to my, back to my OB that I said, were you gonna. Mention not to throw my OB under the bus. That's terrible. But I was just a little disappointed, I was like, could you, I wanted her to know that I had to go to my pharmacist and that she should be telling her patients to get the vaccine.
[00:38:33] Dr. Anetta Regan: And the response I got was pretty, it was. Yeah, you can get the flu vaccine if you want to get it. And I was like no, don't tell me that they, you should be getting it because I don't want you to get flu and I want you to have those antibodies. I want you to be protected in the flu season and I want the baby to have protection too.
[00:38:50] Dr. Anetta Regan: So it was just, it was not very strong. And then I moved to California when I was in my second trimester and it was like. Polar like night and day. I have my intake and she's so at 28 weeks, you're going to be getting your, Oh, she didn't say you're going to be getting it, but she's that's when you're supposed to get your Tdap dose.
[00:39:08] Dr. Anetta Regan: So we're going to do it right here on that, on, your appointment that day. Yep. See? And I'm like, great. She's did you get your flu vaccine? Cause you haven't, if you haven't, we're going to get it, it's a little late in the season, but you'll get it now. And I'm like, don't worry. I took care of it, but it was just, it was interesting to see like how very different your different providers can be in terms of recommending it or not recommending it.
[00:39:31] Dr. Anetta Regan: And it can be a really, it is a very important factor and whether people get the vaccine.
[00:39:36] Dr. Jill Baker: So would you recommend for women that are pregnant? To, advocate for themselves if they feel that These conversations are not coming up during their visits with their OB, with their
[00:39:50] Dr. Anetta Regan: OBGYN.
[00:39:51] Dr. Anetta Regan: Yes, 100%. We know this is a major issue. I've heard you speak previously and I know you've given this very excellent advice. Yeah, we, I think we need to be our own advocates and I think that's why It is really important to work at this from the, to provide education to health providers and try and enhance those conversations between providers and their patients.
[00:40:16] Dr. Anetta Regan: But I think we also need to be working from the patient level and letting people, increasing awareness and education around vaccines, how it can support your health, providing that information that people want to make them feel better about whatever they decide if they're going to get the vaccine or not.
[00:40:32] Dr. Anetta Regan: But at least Giving them that information and yeah advocating for yourself have that conversation like I had to do so I didn't get offered the vaccine, but I knew I should have it So I went and spoke to somebody else and they gave it to me That is exactly what I think, if you're in a setting where they're not recommending it ask for it Talk about it advocate for yourself.
[00:40:55] Dr. Anetta Regan: I love that. I love that.
[00:40:57] Dr. Jill Baker: Have you found that I would say with the maybe the covid vaccine itself and Barriers and feelings about it. Did you yourself, were there any differences between kind of women's feelings about the vaccine, depending on their race or ethnic background, or was it the same feeling overall, the same kind of concerns regardless?
[00:41:26] Dr. Anetta Regan: I think from what I've seen, the concerns are similar. So it's still the concerns about safety. We do see differences though, in terms of that get getting that recommendation. So we have seen people who get their care from, so like I did some work in Australia where we found if you've got most of your.
[00:41:50] Dr. Anetta Regan: prenatal care from a private midwife or from a general practitioner that you were less likely to be recommended a vaccine compared to somebody seeing an obstetrician, a private obstetrician. And I think we see that in the U S as well, that, depending on what kind of healthcare setting you're in, you may be more or less likely to be recommended a vaccine.
[00:42:14] Dr. Anetta Regan: And we also see that by race and ethnicity. So we do see that black mothers. Hispanic mothers, they are less likely to be recommended the vaccine than white, and that likely translates to lower vaccination rates are definitely lower. And we're currently doing some work to look at all all currently recommended vaccines based on the payment system that you're in.
[00:42:37] Dr. Anetta Regan: If you're privately insured versus if you're in the Medicaid system and I'm not to depress anybody, but it I think it's. Very disappointing to see that in the Medicaid population uptake of these recommended vaccines that have the potential to, protect you and your baby are almost half the rate of the privately insured population.
[00:43:02] Dr. Anetta Regan: So there's definitely visible disparities. Part of it's linked to health care providers being less likely to get that health care provider recommendation. Let's hold.
[00:43:13] Dr. Jill Baker: Can we pause for one second? I have to let the dog out. I'm just going to press pause. Hold on one sec. Here we go. Yay. All right.
[00:43:22] Dr. Jill Baker: Awesome. So with that knowledge, how can women and women of color and women in different, socioeconomic backgrounds, what do you recommend that, that they can do to make sure that They can get the vaccines that they need to get.
[00:43:46] Dr. Anetta Regan: Yeah, so I think it's important to just going back to that self advocacy piece feeling like they can, if you don't like, if you don't feel like you're getting the information you need from your provider, change provider, find the one that, that is going to work with you and is going to talk to you about the things that you think you need during your pregnancy and if You're unhappy with The information that you're getting on vaccines.
[00:44:13] Dr. Anetta Regan: Go somewhere else. But make sure you advocate for yourself. But if you want that vaccine, you can get it. There's multiple places you can go. It doesn't even just have to be your prenatal care provider. You can go to your primary care provider and ask and they should be Offering you the vaccine you can go to I sorry I just really love that we can get a vaccine in a pharmacy.
[00:44:35] Dr. Anetta Regan: Here like we need to make vaccines easy Parenthood is Such a crazy time. It's crazy while you're pregnant. It's crazy after you're pregnant the easier we can make Vaccines, the better. So even being able to walk into your, while you're grocery shopping and step over to the pharmacist and say, Hey, I'm pregnant.
[00:44:56] Dr. Anetta Regan: Can I get my flu vaccine? I'm not sure. I might need my COVID vaccine too, but having that, feeling like you can have that conversation with whoever that might be that you trust the most, have that conversation and speak up for yourself. I love that.
[00:45:12] Dr. Jill Baker: I love that. That's so important. So one question that I have for you that I ask to everyone on my show is why do you think maternal health is an emergency in this country?
[00:45:31] Dr. Anetta Regan: Yeah, I saw that question. I was like, whoo, that is a hard one. That is a hard one. It's, I think it's just, it's not hard. It's just very complex because I think there's a lot of different issues. So one is the fact that health in general, I think is an emergency in this country. And then pregnancy is this time where things just amplify.
[00:45:54] Dr. Anetta Regan: So if you were in a, Okay. If you were in a place where maybe health wasn't the best before you became pregnant now that you're pregnant that just really exponentially Increases as a problem. So if things get things are maybe a small problem before you're pregnant now you're pregnant And this is a big problem a very big problem and it's affecting not just you.
[00:46:15] Dr. Anetta Regan: It's also affecting the baby so I think the fact that We are not necessarily fantastic at keeping people healthy, all the way from birth through adulthood. That's a preexisting problem that becomes even bigger during pregnancy. And then I think we also have, our health system is. Having lived outside of the U.
[00:46:36] Dr. Anetta Regan: S. health system and seeing a very different one in Australia, our health system is funky. There are some, there are a lot of, sorry, not some, there's a lot of pinch points. And we don't always... We don't always know, you don't always know that you're not in a great, you're not seeing a great provider.
[00:46:54] Dr. Anetta Regan: You don't always know that you're not getting the best care, so I think that's a really big problem because you might think that you're getting fantastic prenatal care you're following, you're doing whatever they say, but
[00:47:09] Dr. Jill Baker: It's just average, and you don't know. Yeah, and
[00:47:12] Dr. Anetta Regan: they're not Or less than average.
[00:47:14] Dr. Anetta Regan: Yeah, and there's certain things that are not being done that are not picking up problems that are going to become major when you get closer to delivery. So I think that, the system is also a bit of a problem. And then, I think we are doing better now at paying attention to it. I think we know.
[00:47:32] Dr. Anetta Regan: It's a frustrating situation 'cause I keep seeing these articles about how maternal mortality is on the rise again. Yeah. Maternal mortality on the rise again. And we just don't seem to be finding this, how how do we a address this? And I think we're in this I don't know.
[00:47:48] Dr. Anetta Regan: We, we need to do something different clearly because The rates are just not going in the direction that we want them to go. And to be honest, I used to be embarrassed to be an American abroad at conferences in Australia and New Zealand, because there'd be an American there and they would present data on so just stepping aside from mothers and looking at infant and perinatal deaths, they would present the data and.
[00:48:11] Dr. Anetta Regan: I'm not kidding. At one conference, at the big perinatal conference, somebody in the audience raised their hand and they asked if that, if the statistics were right, because they said that's so high and you're a high income country. I'm not even kidding. I'm not making this up. And the speaker said, yeah, in the U S we unfortunately have, some of the high, the highest maternal mortality rate, the highest perinatal mortality rate for a high income country.
[00:48:34] Dr. Anetta Regan: And it's on a, it's really unacceptable. So I feel like we really need a we need more attention. We need more funding. We need more research. We need more community engagement. We need to listen more. There's a lot of, there's a laundry list of things that we need to do, but we really need to change and shift how we're addressing this because we're going in the wrong direction.
[00:48:55] Dr. Anetta Regan: And that's
[00:48:55] Dr. Jill Baker: why I started this show. Because exactly all the things that you just, all the things you said, there's so much more work that we have to do. Oh, yeah. So thank you. Thank you for that. But yeah, I thought I also find in other countries. Yeah, I go to conferences. I think people are more they're more comfortable with being candid
[00:49:15] Dr. Anetta Regan: and transparent.
[00:49:16] Dr. Anetta Regan: They're like, what? Can you explain this for me? That's true. I have found that to be true as well.
[00:49:26] Dr. Jill Baker: Oh, you all are very comfortable. We don't talk to each other like that in the US. Although, yeah, it's the same data. It doesn't make sense. Yeah, we know. Yeah. So I thought before we, we leave and I, I see this as the first time of hopefully many conversations we'll have on the show that we could talk or you could, talk a little bit about the, program.
[00:49:50] Dr. Jill Baker: Your new research grant that I'm, I'm happy that I'm going to be helping you in some capacity. So I thought maybe you could talk a little about it here on this episode before you go.
[00:50:04] Dr. Anetta Regan: Yeah, I'm excited too. We've done a little stuff into adolescence, which has been really fun and a very important, adolescents are going to be they're not too far from young adulthood, really from parenthood, they're a very important group and it's a really interesting stage because, I think.
[00:50:27] Dr. Anetta Regan: When you're under 12 ish there's, your parents are making all the decisions, but that 12 to 17 age point is really interesting because you're starting to develop your independence. You're starting to, identify your own, have your own perceptions and beliefs around things like vaccines and other medical issues and health and your health.
[00:50:49] Dr. Anetta Regan: You're starting to take on a little more ownership of your own health. So we identify this as a population group that, I've been a researcher at different research institutions. One was a pediatric one. And we talked about this all the time about how teens just get left out a lot. And I'm sure you guys have found that it.
[00:51:08] Dr. Anetta Regan: Yeah. Center for teen parents. Yeah. Yeah. We tend to focus on the little kids. And then we kind of skip to adults, even
[00:51:17] Dr. Jill Baker: like the old, yeah, younger, older adolescents or younger
[00:51:21] Dr. Anetta Regan: adults. Yeah. But teens get left out. And we've seen this emerging as a really important issue with COVID because there are teens that want to get vaccinated, but they're Their parents, are not happy.
[00:51:34] Dr. Anetta Regan: And so there's this question of, can you allow a teen to consent themselves or some states that they'll allow it as long as the team can show that they understand the risks and the benefits. So it's a really big question mark and very important. So we managed to get this. Rant from NIH and we were I was super stoked that you Jill wanted to help on this.
[00:51:55] Dr. Anetta Regan: We've already learned.
[00:51:56] Dr. Jill Baker: This is my jam
[00:52:01] Dr. Anetta Regan: Again I feel like this is fate serendipity or whatever, I think I cold called you guys yeah, and I was like you guys have a Center for teen parent communication, which seems like and
[00:52:14] Dr. Jill Baker: I was like, she's emailing me.
[00:52:17] Dr. Anetta Regan: No, it's great. We've already done. We've already learned a lot from your previous HPV work and we're really grateful for your partnership and also the contributions by Dr Miller.
[00:52:28] Dr. Jill Baker: Shout out Dr. Victoria Miller.
[00:52:30] Dr. Anetta Regan: Yeah. So so anyways, the goal of this project is to look at we're really interested and trying to better understand how teens are either getting vaccinated or not vaccinated. And we're investigating this interface between teens and their parents. And it's been really interesting.
[00:52:51] Dr. Anetta Regan: So we're going to be doing a really big national survey. That's going to go out in August where we're going to have, over 750 teens and parents completing this survey. And we can actually model, who the major influencer is. Is it the parent? Is it the teen? Is it 50, 50? But what we've.
[00:53:09] Dr. Anetta Regan: Yeah, what we've done. So and we want to use this to try and help support adolescent vaccine decision making. But what we've done so far is we've spoken to some teens and some parents. We've done some interviews with them. And that's been with your help, Jill. And yeah, it's been really interesting hearing.
[00:53:25] Dr. Anetta Regan: I just think the yeah, this
[00:53:27] Dr. Jill Baker: is new so you got to hear from their voices and their perspectives. Yeah,
[00:53:32] Dr. Anetta Regan: it's been so the teens are You know some of them are really happy to talk. Some of them are like, I do whatever my mom tells me to do. And I'm like, yeah, Cameron, my son, you better be listening to this.
[00:53:45] Dr. Anetta Regan: I do whatever my mom, I'm just kidding. He's not going to, he's not going to do anything. I told him that's not going to happen, but So I have a feeling it's going to be, it's going to really depend on, there's going to be these different subgroups of teens, but what's been really nice is some of the parents have actually told us how much they like doing these interviews because some of them, we wanted to talk to them separately, but some of them have been in the same room, which is You know, totally fine.
[00:54:12] Dr. Anetta Regan: But the parent will actually usually come back and say, wow, I'm really glad you're doing this research. That was actually really interesting to hear what my teen said about, yeah, what they were there. Their recollection of when we talked about it and. Why we decided not to or why we decided to do it.
[00:54:31] Dr. Anetta Regan: And we've actually had a few parents say just how much they liked doing this, that somebody was doing this study and yeah, when you hear
[00:54:40] Dr. Jill Baker: that that just That is, for me, I always find that's a confirmation. And it is interesting with the HPV vaccine program, the parents We're very happy that we were there and had this program and said, we, this is going to be your program.
[00:55:00] Dr. Jill Baker: We want to hear from you. What do you need? And they were like people don't really always ask us what we think or what we need. And
[00:55:10] Dr. Anetta Regan: exactly. Yeah. And I think it's really like going full circle back to why did you do this? Why did you get into this field?
[00:55:17] Dr. Anetta Regan: And I think it's experiences like that, where you actually hear somebody telling you, I'm so glad you're doing this. I'm so glad you're documenting this. I'm so glad you're telling our story. I'm so glad you're trying to like address this problem. It just makes you feel Good and like what you're doing matters matter.
[00:55:35] Dr. Anetta Regan: Yeah, exactly. So I'm I think we're gonna learn a lot and we're definitely gonna i'm really grateful to have you jill and so i'm my honor I think this is gonna i'm hoping we can take this beyond, kovas important and vaccination rates are not great in teens I think we're still at around 62 something like that would be a lot better.
[00:55:58] Dr. Anetta Regan: It could be a lot better and But I'm hoping we can take this and continue to learn more, maybe revisit HPV and I know you've already learned a lot in the HPV space, but maybe we could continue to learn more and see how it compares to COVID and other vaccines that teens should be getting.
[00:56:17] Dr. Anetta Regan: So I think it's a really interesting space and we're going to learn a lot. We're still only in, just coming out of year one.
[00:56:24] Dr. Jill Baker: Year one, that's right. So I can't wait. So anyway when you have some results, you can talk about it on the show.
[00:56:31] Dr. Anetta Regan: Yeah, we we have two projects that are probably going to wrap up so that those early interviews.
[00:56:38] Dr. Anetta Regan: And then we just finished a systematic review, which isn't always the sexiest thing to talk about.
[00:56:43] Dr. Jill Baker: No, it's not the sexiest public health thing. But it's important. It's important. Exactly. You said it right. It's not the sexiest thing that we do.
[00:56:53] Dr. Anetta Regan: We did learn a lot. So I could share with you we'll have a summary of that over the summer.
[00:56:57] Dr. Anetta Regan: And essentially I'd be able to come and tell you these are why, these are the reasons why teens are not getting COVID vaccine. And these are reasons. Why they are and I can also, I can tell you there's a lot there's that systematic review has been a challenging, challenging to say the least.
[00:57:15] Dr. Anetta Regan: It's, there's a lot of data out there, but Right, I
[00:57:17] Dr. Jill Baker: have close to a dearth of data or
[00:57:21] Dr. Anetta Regan: Little data. Yeah, which is a different problem, but but yeah, we're learning a lot about why teens get a vaccine or where they don't and it should come as no surprise that it's very different to what the reasons why adults don't get the vaccine completely
[00:57:36] Dr. Jill Baker: right.
[00:57:37] Dr. Jill Baker: The role of why we research it,
[00:57:40] Dr. Anetta Regan: we can talk about, we can talk about this more, but one thing that has been very interesting is just the role of your peer groups, which comes as no surprise from other things alcohol use, but I actually did not think peer influence was going to be so strong with vaccines.
[00:57:58] Dr. Jill Baker: Oh, it is. Oh, it is. We got it. Then that means it's okay.
[00:58:03] Dr. Anetta Regan: Oh, it's actually there's, I think there's some stigma there to not getting the vaccine. There are some teams that are saying like their friends wouldn't hang out with them because they weren't vaccinated. And and that was yeah. It's, I think it's much more extreme than other I don't see, I don't see teens, ostracizing a friend because they didn't get the HPV vaccine,
[00:58:24] Dr. Jill Baker: Flu. Yeah, cOVID. Yeah, you're right.
[00:58:26] Dr. Anetta Regan: COVID flu. What? I'm pretty sure that's what most teens. Yeah.
[00:58:30] Dr. Jill Baker: Yeah. My kids sometimes have come home from school and said, oh this person isn't vaccinated. Now I can't hang
[00:58:38] Dr. Anetta Regan: So that's been really, that, I think that's one of our early, really interesting findings is just how important your peer network is.
[00:58:47] Dr. Anetta Regan: Yes, and I wasn't expecting teens to like group themselves or ostracize people because Of their vaccination status, but right, we've definitely seen that like across a couple of our participants.
[00:59:02] Dr. Jill Baker: That's going to be a show by itself. That'll be our next show. Yeah.
[00:59:10] Dr. Anetta Regan: Take care of
[00:59:11] Dr. Jill Baker: routines. See you all week.
[00:59:12] Dr. Jill Baker: Public Health Week.
[00:59:18] Dr. Jill Baker: Definitely. But thank you Annette so much. And thank you to all the guests for tuning in this week. Dr. Reagan, can you let the listeners know how they can find or connect with you on social media or how they can find, if they have a question about your research, however, whatever you want to share.
[00:59:40] Dr. Anetta Regan: Yeah, a couple different places you can find me. So I'm on Twitter at Annette K. Regan. You can find me on LinkedIn at Dr. Annette Regan. And then I also have a personal website that I try to keep up. Your
[00:59:53] Dr. Jill Baker: personal website is dope. And we'll make sure that this is on your On your description
[01:00:00] Dr. Anetta Regan: page. I try to keep it updated.
[01:00:03] Dr. Anetta Regan: I don't always do a fantastic job, but I like it because I try to put summaries in there of what we found and what we're doing, what we're working on right now. So that'd be another place if you want to just have a look at what we're working on. Yeah, a couple of different places to find me on social media.
[01:00:18] Dr. Anetta Regan: Thank
[01:00:19] Dr. Jill Baker: you so much, and thank you all for tuning in to the show this week. Thank you for listening to this episode of Maternal Health 9 1 1. Please follow the show on Instagram, Facebook, and Twitter. Feel free to DM me with your questions and thoughts, or to share your infertility, fertility, and maternal health story.
[01:00:42] Dr. Jill Baker: For more information on this podcast and your host, Visit www. drjoebaker. com. Listening to the show on Apple podcast, please rate and review it. It really helps the show and the feedback is welcome.
As the statistics show, maternal health in the United States continues to be a concern, with significant disparities based on race and ethnicity. However, there are steps that can be taken to improve outcomes for pregnant women and reduce the risks associated with childbirth.
One promising approach is the use of maternal vaccines, which can help protect both the mother and the infant from preventable illnesses. Vaccines can be administered during pregnancy to protect against diseases such as influenza, pertussis, and tetanus.
Here are some key points to consider regarding maternal vaccines:
Vaccines are safe and effective for pregnant women: According to the Centers for Disease Control and Prevention (CDC), vaccines are safe and effective for pregnant women. In fact, getting vaccinated during pregnancy can help protect both the mother and the baby from serious illnesses.
Vaccines can reduce the risk of preterm birth: As the data shows, women of color are at a higher risk of preterm birth. However, studies have found that getting vaccinated during pregnancy can help reduce the risk of preterm birth and other complications.
Access to vaccines is crucial: In order to address disparities in maternal health outcomes, it is important to ensure that all pregnant women have access to vaccines. This includes addressing barriers such as cost, transportation, and language barriers.
Providers play a key role in promoting vaccination: Healthcare providers can play a key role in promoting vaccination among pregnant women. This includes providing education about the safety and effectiveness of vaccines, as well as addressing any concerns or questions that patients may have.
Overall, maternal vaccines have the potential to improve outcomes for pregnant women and reduce the risks associated with childbirth. By addressing disparities in access to vaccines and promoting vaccination among pregnant women, we can take important steps towards improving maternal health in the United States.
Guest Bio:
Annette Regan is a perinatal and pediatric infectious disease epidemiologist with over 16 years of experience leading epidemiologic research and public health practice. She completed an MPH in epidemiology at the Rollins School of Public Health, Emory University in 2006, and a PhD in infectious diseases at the University of Western Australia in 2016. She has previously worked as an epidemiologist for state and federal public health agencies, including the US Centers for Disease Control and Prevention (CDC). During her time at CDC, she coordinated national surveillance activities and had the opportunity to serve in emergency response operations, including the response to the 2009 influenza A/H1N1 pandemic. After leaving CDC in 2011, she spent seven years living in Australia working for the state health department in Western Australia. During her time there, she implemented several communicable disease prevention and surveillance programs, including the development of novel SMS-based surveillance tools for monitoring vaccine safety during pregnancy and emerging infectious disease threats such as Ebola virus. Since returning to the US in 2018, she has been faculty at the Texas A&M University School of Public Health, where she lectured on epidemiologic methods, infectious disease epidemiology, and reproductive health and served as the Deputy Director of the Maternal and Child Health program. She is currently tenure-track faculty at the University of San Francisco in the School of Nursing and Health Professions.
Her research program aims to support and promote maternal and child health - including topics such as maternal vaccines (vaccines given during pregnancy), perinatal infection, birth spacing, and vaping and tobacco use during pregnancy. She currently serves as the PI on several NIH awards to evaluate the uptake, safety and effectiveness of COVID-19 vaccines during pregnancy and to identify and address barriers to adolescent COVID-19 vaccination. Her research has been published in >100 peer-reviewed papers in journals such as the Lancet, Lancet Global Health, Lancet Infectious Diseases, JAMA, BMJ, American Journal of Epidemiology and obstetric journals. In addition to her research and teaching, Annette serves on several global committees to improve global vaccine safety surveillance, with a special focus on vaccines administered during pregnancy.
In her personal life, she spends as much time as possible swimming, hiking and nature walking with her husband and two year old son (a pandemic baby!)
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