Countering COVID-19 Vaccine Hesitancy in Pregnancy: the “4 Cs”

Abstract

Despite evidence to support the safety and efficacy of COVID-19 vaccination in pregnancy, and clear recommendations from professional organizations and the CDC for pregnant people to get vaccinated, COVID-19 vaccine hesitancy in pregnancy remains a significant public health problem. The emergence of the highly transmissible B.1.617.2 (Delta) variant among primarily unvaccinated people has exposed the cost of vaccine hesitancy. In this commentary, we explore factors contributing to COVID-19 vaccine hesitancy in pregnancy and potential solutions to overcome them.

COVID-19 in pregnancy: implications for fetal brain development

“…in utero worldwide could reach up to 20 million per year, particularly in the setting of low COVID-19 vaccine uptake in pregnant populations [23,24]. In fact, a 12-month follow-up of more than 7000 deliveries in a large hospital system, including more than 200 COVID-19-exposed pregnancies, suggested that prenatal SARS-CoV-2 infection is associated with an increased risk for offspring neurodevelopmental diagnoses [25].…”

Severe COVID-19 in pregnancy is almost exclusively limited to unvaccinated women – time for policies to change

“…Compounded by their exclusion, there is considerable vaccine hesitancy amongst pregnant women. 2 Such hesitancy persists, even though at present adverse outcomes of SARS-CoV-2 infection are increasing among pregnant and postpartum women in many countries, 3 while these are improving in most other groups. The impact of the omicron variant is, as yet, unknown.…”

COVID-19 Vaccination in Obstetrics and Gynecology: Addressing Concerns While Paving a Way Forward

“…Lack of confidence about the safety of the vaccine in pregnancy as well as concern for potential risks to the fetus are the most common reasons for vaccine hesitancy in reproductive-aged women. 2 The decision to exclude pregnant and lactating individuals from early COVID-19 vaccine clinical trials has confirmed what we knew all along—the absence of medical information can be just as harmful as misinformation.…”