Attitudes toward COVID-19 illness and COVID-19 vaccination among pregnant women: a cross-sectional multicenter study during August-December 2020

Abstract

Objective: Evaluate pregnant women's attitudes toward COVID-19 illness and vaccination and identify factors associated with vaccine acceptability. Study Design: Cross-sectional survey among pregnant women enrolled in a prospective COVID-19 cohort study in Salt Lake City, UT, Birmingham, AL, and New York, NY, August 9-December 10, 2020. Women were eligible if they were 18-50 years old and <28 weeks of gestation. Upon enrollment, women completed surveys regarding concerns about COVID-19 illness and likelihood of getting COVID-19 vaccine if one were available during pregnancy. Vaccine acceptability was defined as a response of "very likely" or "somewhat likely" on a 4-point Likert scale. Factors associated with vaccine acceptability were assessed with multivariable logistic regression. Results: Of 939 pregnant women eligible for the main cohort study, 915 (97%) consented to participate. Among these 915 women, 39% self-identified as White, 23% Black, 33% Hispanic, and 4% Other. Sixty-two percent received an influenza vaccine last season. Seventy-two percent worried about getting sick with COVID-19. If they were to get sick, 92% worried about harm to their pregnancy and 80% about harm to themselves. Only 41% reported they would get a vaccine. Of women who were unlikely to get vaccinated, the most frequently cited concern was vaccine safety for their pregnancy (82%). Non-Hispanic Black and Hispanic women had lower odds of accepting a vaccine compared with non-Hispanic White women (adjusted odds ratios (aOR) 0.4, 95%CI 0.2-0.6 for both). Receipt of influenza vaccine during the previous season was associated with higher odds of vaccine acceptability (aOR 2.1, 95%CI 1.5-3.0). Conclusion: Although most pregnant women worried about COVID-19 illness, <50% were willing to get vaccinated during pregnancy. Racial and ethnic disparities in plans to accept COVID-19 vaccine highlight the need to prioritize strategies to address perceived barriers among groups at high risk for COVID-19.

COVID-19 Vaccine Acceptability Among Women Who are Pregnant or Planning for Pregnancy in Saudi Arabia: A Cross-Sectional Study

“…40 Another study in the US conducted on 939 pregnant women reported that only 41% of the participants would get a vaccine, and 82.0% of the participants were concerned about vaccine safety for their pregnancy. 41 This study showed that pregnant women and those planning to get pregnant had higher scores of hesitancy regarding taking the vaccine in comparison to women who are not pregnant or not planning to be pregnant. One of the most important factors that increase hesitancy to receive vaccination are problems of trust and hearing or reading about negative events from different sources.…”

The risk factors and pregnant women's willingness toward the SARS-CoV-2 vaccination in various countries: A systematic review and meta-analysis

“…There were 15,444 participants in all that participated in the study. [16][17][18][19][20][21][22][23][24][25][26][27] Table 1 is based on a review of 12 cross-sectional studies that looked at risk factors and pregnant women's desire to have the SARS-CoV-2 vaccine in various countries. This research revealed variables related to willingness of SARS-CoV-2 vaccination among pregnant women > 35 years, higher school education, sufficient information about the SARS-COV-2 vaccine, high perception, good practice, received influenza vaccine last year and third trimester.…”

Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection at the time of birth in England: national cohort study

“…This has motivated widespread hesitancy about recommendation of vaccination to all pregnant women, with governments and professional organizations initially recommending offering vaccination to pregnant women at high risk of either occupational exposure or severe disease 35 and pregnant women reluctant to take up a vaccine offer. 36 In the United States and Israel, where vaccination has been recommended to those at a higher risk, initial data provide a positive signal of safety and efficacy in pregnant women. 33,37,38 Further evidence of a link between SARS-CoV-2 infection and an increased risk of fetal death may motivate prioritization of, and encourage pregnant women to access, vaccination.…”