Pregnant women were excluded from vaccination against Coronavirus 2019 (COVID-19) until September 2021 in South Korea. Although vaccination for pregnant women started in October 2021, vaccine acceptance in pregnant women is yet unknown. This cross-sectional study aimed to investigate COVID-19 vaccine acceptance during pregnancy and influencing factors. An anonymous survey was distributed in obstetrics departments to all pregnant or postpartum women, during the prenatal or postpartum visit. The proportion of self-reported COVID-19 vaccination during pregnancy among 436 women was 26.6%. Pregnancy-related independent factors influencing maternal COVID-19 vaccination were “received vaccine information about from obstetrics and gynecology (OBGYN) doctors” (OR 3.41, 95% CI 2.05–5.65), “cohabitant COVID-19 vaccination” (OR 2.43, 95% CI 1.06–5.59), and “second trimester” (OR 7.35, 95% CI 1.54–35.15). In women who did not want to get vaccinated, the most common reason for COVID-19 vaccination hesitancy was concern that COVID-19 vaccine might affect the fetus (91.7%, 243/266), followed by distrust in COVID-19 vaccine effectiveness (42.6%, 113/266). This study showed that providing information about maternal COVID-19 vaccination, especially by OBGYN doctors, is crucial for increasing vaccination coverage in pregnant women. Providing updated evidence of COVID-19 vaccine efficacy and safety in pregnant women may be also helpful for increasing vaccine acceptance.

Purpose: To analyze the overall knowledge and attitude of healthcare providers regarding coronavirus disease (COVID-19) vaccine recommendations for pregnant women and factors affecting these opinions in Korea.Methods: We conducted a nationwide survey study of obstetricians and gynecologists registered in the Korean Society of Obstetrics and Gynecology. The knowledge, attitude, and factors affecting COVID-19 vaccination in pregnant women were investigated.Results: Among 258 participants, 182 (70.5%) answered that they recommended COVID-19 vaccination for pregnant women, while 76 (29.5%) answered that they did not. The administrative district of the physician's healthcare center and knowledge regarding adverse reactions to the COVID-19 vaccine were factors affecting opinions on vaccine recommendation. Physicians working in metropolitan cities were 7.3 times more likely to recommend COVID-19 vaccination to pregnant women than those working in Seoul. Physicians aware of the COVID-19 vaccine safety profiles in pregnant women were 25.36 times more likely to recommend vaccines than those who were not. A significantly higher proportion of the recommended group provided vaccine information to pregnant women compared to the nonrecommended group and also recommended booster shot vaccination. Guidelines from academic societies (70.9%) and from government and public centers (64.8%) were important factors in the recommendation group, while additional study results (57.1%) were important factors in the nonrecommendation group. This information will be useful for future reference regarding vaccine recommendations.Conclusion: Providing guidelines and recent data regarding COVID-19 vaccination in pregnant populations to healthcare providers will promote obstetricians and gynecologists to recommend vaccination to pregnant patients and will thereby contribute to achieving herd immunity in Korea.