COVID-19 vaccine acceptance among pregnant, breastfeeding, and nonpregnant reproductive-aged women

Abstract

Background Although mass vaccination against COVID-19 may prove to be the most efficacious end to this deadly pandemic, there remains concern and indecision among the public towards vaccination. As pregnant and reproductive-aged women account for a large proportion of the population with particular concerns regarding vaccination against COVID-19, this survey aims at investigating their current attitudes and beliefs within our own institution. Objective To understand vaccine acceptability among pregnant, non-pregnant and breastfeeding respondents and elucidate factors associated with COVID-19 vaccine acceptance. Methods We administered an anonymous online survey to all women (including patients, providers and staff) at our institution assessing rates of acceptance of COVID-19 vaccination. Respondents were contacted in one of three ways: by email, advertisement flyers and distribution of QR codes at virtual townhalls regarding the COVID-19 vaccine. Based on their responses, respondents were divided into three mutually exclusive groups: (1) non-pregnant respondents (2) pregnant respondents and (3) breastfeeding respondents. The primary outcome was acceptance of vaccination. Prevalence ratios were calculated to ascertain the independent effects of multiple patient-level factors on vaccine acceptability. Results The survey was administered from January 7, 2021 to January 29, 2021 with 1,012 respondents of whom 466 (46.9%) identified as Non-Hispanic White, 108 (10.9%) as Non-Hispanic Black, 286 (28.8%) as Hispanic, and 82 (8.2) as Non-Hispanic Asian. The median age was 36 (IQR 25-47) years. Of all the respondents, 656 respondents (64.8%) were non-pregnant, 216 (21.3%) were pregnant and 122 (12.1%) were breastfeeding. There was no difference in chronic comorbidities when evaluated as a composite variable (Table 1). 390 respondents (39.2%) reported working in healthcare. Non-pregnant respondents were most likely to accept vaccination (457 respondents, 76.2%, p<0.001) with breastfeeding respondents the second most likely (55.2%). Pregnant respondents had the lowest rate of vaccine acceptance (44.3%, p<0.001). Prevalence ratios revealed all non-White races except for non-Hispanic Asian respondents and Spanish speaking respondents were less likely to accept vaccination(Table 3). Working in healthcare was not found to be associated with vaccine acceptance among our cohort. Conclusions and Relevance In this survey study of only women at a single institution, pregnant respondents of non-White or non-asian races were more likely to decline vaccination compared to non-pregnant and breast-feeding respondents. Working in healthcare was not associated with vaccine acceptance.

Predictors of pregnant women’s intention to vaccinate against coronavirus disease 2019: A facility-based cross-sectional study in southwest Ethiopia

“… 23 – 25 However, the finding is much lower when compared with previous studies conducted in different countries. 1 , 26 – 29 The discrepancy in the above finding might be attributable to the study setting difference where our study employed face-to-face interviews, whereas the other studies were web-based surveys. Besides, since our study participants were pregnant women, more negative responses could occur as pregnant women might have apprehension of vaccine effect on pregnancy.…”

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

“…A recent study conducted in the United States among a similar study population that explored COVID-19 vaccination acceptance among pregnant, non-pregnant and breastfeeding women reported that non-pregnant women were most likely to accept vaccination (76.2%), with breastfeeding women the second most likely to accept vaccination (55.2%); pregnant women had the lowest rate of vaccine acceptance (44.3%). 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.…”

“…42 Previous studies investigating the acceptance of taking the COVID-19 vaccine have shown similar results. 30,40,[43][44][45] One study conducted in Turkey in 2021 reported a lower rate of COVID-19 vaccine acceptability, with only 37% stating that they intend to receive the vaccine if it were recommended for pregnant women. 45 Similar results were reported in a large study that included 16 countries across the world, with only 52.0% of pregnant women reporting that they will take the vaccine compared to 73.4% of nonpregnant women.…”

COVID-19 Vaccine Concerns and Acceptability by Language in a Marginalized Population in Rhode Island

“…Only a few studies have been documented that include Spanish speakers and compare results across language groups. 11 , 12 …”