Devon Greyson

Investigator, BC Children’s Hospital

How do perceptions of Covid-19 risk influence health decisions in pregnancy?
Pregnant people have a higher risk of severe COVID-19 disease than non-pregnant people, exemplified in higher rates of hospitalization, intubation, and death than similar age and sex-matched peers. As in the general population, COVID-19 infection rates in pregnant people vary, with racialized people, low income people and those who live in high density neighbourhoods more likely to be infected. Most pregnant people identify as women, and women have been disproportionately impacted by the COVID-19 pandemic. Beyond the biomedical risk of disease, the well-being of mothers has also been jeopardized by COVID-19 policies resulting in higher rates of intimate partner violence, mental health distress, employment and income loss tied in part to increased childcare responsibilities. Trans and non-binary people have also faced disproportionate pandemic-related challenges to mental health, violence, income loss, and access to healthcare.

This project examines individual health decisions that occur within these structural environments, describing their accumulated impact on key pregnancy outcomes and care indicators related to vaccination, perinatal care, social supports and mental health. The decisions made during pregnancy have longitudinal impacts on the life of the pregnant person, future child, and family. Given the evidence of the particularly difficult situation faced by pregnant people, and the importance of these health decisions, it is important to understand how pandemic circumstances have shaped health decision-making. Understanding how and why pregnant people are making health decisions allows for better clinical and social support as the pandemic endures and will inform future policy planning. As Co-PI, I lead the BC-based team and the Vaccination theme within this study.

Immunization Passports for COVID-19: Scientific, Ethical, Policy and Design Implications
Globally, unprecedented measures have been implemented to reduce the spread of the COVID-19 pandemic and prevent healthcare systems from being overwhelmed. These measures include states of lockdown, travel restrictions, work from home orders and quarantine of citizens. Proof-of-vaccination requirements have long been in use to identify healthcare providers, students, and travelers who are or are not vaccinated. During the COVID-19 pandemic, digital vaccination certificates have been introduced and used to restrict access to locations or services to the public base on vaccination status.

The purpose of this project is to evaluate the ethical, legal and public health implications of the use of immunization passports in Canada and provide guidance on potential design and evaluation strategies for Canada. As part of this project, I am conducting key stakeholder consultations, in order to develop recommendations for evaluation and future use of immunization passport technologies in Canada, looking both at and beyond the current COVID-19 pandemic.

SPPH 621 – Approaches to Enquiry in Population and Public Health