Background
Despite high rates of COVID-19-related maternal mortality, Jamaica currently has little data on COVID-19 vaccine uptake among pregnant women.
Study Design
We conducted a cross-sectional, web-based survey of 192 reproductive-aged women in Jamaica from February 1- 8, 2022. Participants were recruited from a convenience sample of patients, providers, and staff at a teaching hospital. We assessed self-reported COVID-19 vaccination status and COVID-19-related medical mistrust (operationalized as vaccine confidence, government mistrust, and race-based mistrust). We used multivariable modified Poisson regression to test the association between vaccine uptake and pregnancy.
Results
Of 192 respondents, 72 (38%) were pregnant. Most (93%) were Black. Vaccine uptake was 35% in pregnant women versus 75% in nonpregnant women. Pregnant women were more likely to cite healthcare providers versus the government as trustworthy sources of COVID-19 vaccine information (65% vs. 28%). Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination (adjusted prevalence ratio (aPR) and 95% confidence interval (CI) 0.68 (0.49 - 0.95); 0.61 (0.40 - 0.95); and 0.68 (0.52 - 0.89) respectively). Race-based mistrust was not associated with COVID-19 vaccination in the final model.
Conclusion
Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination among reproductive-aged women in Jamaica. Future studies should evaluate the efficacy of strategies proven to improve maternal vaccination coverage, including standing “opt-out” vaccination orders and collaborative provider and patient-led educational videos tailored for pregnant individuals. Strategies that decouple vaccine messaging from government agencies also warrant evaluation.