COVID-19 Vaccine Acceptance during Pregnancy and Influencing Factors in South Korea

Abstract

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.

COVID-19 Vaccine Acceptance of Pregnant Women in Thailand

“…These findings align with studies conducted in various countries, including the USA, China, France, the UK, Czechia, Switzerland, Turkey, India, South Korea, and Malaysia. [13][14][15][16][17][18][19][20][21]24 Notably, our study found that medical health provider recommendations were a significant factor that could nearly double the COVID-19 vaccine acceptance rate. This is consistent with the broader population in Thailand, where information from healthcare professionals is considered the most trustworthy source.…”

“…In contrast, countries like the UK (62.1%), Czechia (76.6%), India (78.52%), China (77.4%), and Malaysia (77.1%) demonstrate higher rates of willingness to receive the COVID-19 vaccine. [13][14][15][16][17][18][19][20][21]24 The predominant reason for vaccine hesitancy among Thai pregnant women was the fear that the vaccine might harm their babies, which likely contributed to the lower vaccine acceptance rate observed in our study. Interestingly, a different study conducted in Thailand reported a higher acceptance rate of 60.8%, 25 highlighting the contrasting results within the same country.…”

“…13 European trends varied, with the UK and Czechia reporting acceptance rates exceeding 62.1% and 76.6%, whereas Turkey, Switzerland, and France observed lower rates of 37%, 29.7%, and 29.5%, respectively. [14][15][16][17][18] In Asia, South Korea recorded a 26.6% acceptance rate, 19 while Indian pregnant women displayed a 78.52% acceptance rate. 20 In neighboring Southeast Asia, Malaysia recorded an acceptance rate of 77.1%.…”

Assessing Doubts, Knowledge, and Service Appreciation among Pregnant Women Who Received the COVID-19 Vaccination in an Italian Research Hospital: A Cross-Sectional Study

“…For example, a cross-sectional survey of US pregnant women showed that respondents who were recommended for COVID-19 vaccination by their healthcare provider were 52% more likely to accept the vaccine, reporting fewer concerns about vaccine safety and greater confidence in its effectiveness, compared to respondents with no provider recommendation [17]. Similarly, a Korean study demonstrated that patient education about maternal COVID-19 vaccination on the behalf of obstetrics and gynecology doctors is pivotal in increasing vaccination coverage [39]. Furthermore, a report from the CDC found that healthcare provider recommendations were associated with a higher likelihood of COVID-19 vaccination (77.6% vs. 61.9% of adults who did not receive a recommendation) [40].…”

Accuracy of Self-Reported COVID-19 Vaccination Status Compared With a Public Health Vaccination Registry in Québec: Observational Diagnostic Study

“…In particular, real-world evidence can help understand vaccine effectiveness against different disease severities in different susceptible populations often excluded from clinical trials [7], inform policy makers about the length of vaccine protection over time [8], and document rarer side effects [9]. Real-world data can also help understand the evolving prevalence and underlying causes of vaccine hesitancy over time [10] and shape future vaccination campaigns [11,12]. Understanding the role of herd immunity and how to promote vaccination are important questions that need reliable vaccination data [13][14][15][16].…”