COVID-19 Vaccine Acceptance of Pregnant and Lactating Women (PLW) in Czechia: An Analytical Cross-Sectional Study

Abstract

Pregnant and lactating women (PLW) represent a particular population subset with increased susceptibility for COVID-19 morbidity and mortality, even though the evidence about the safety and efficacy of COVID-19 vaccines was delayed due to their initial exclusion from development trials. This unclear situation could have led to increased COVID-19 vaccine hesitancy levels among PLW; therefore, this study aimed to evaluate the attitudes of Czech PLW towards COVID-19 vaccines and the determinants of their attitudes. An analytical cross-sectional survey-based study was carried out in the University Hospital Brno (South Moravia, Czechia) between August and October 2021. The study utilised a self-administered questionnaire (SAQ) adapted from previous instruments used for the same purpose. The SAQ included closed-ended items covering demographic characteristics, clinical and obstetric characteristics, attitudes towards COVID-19 vaccination, and potential psychosocial predictors of vaccine acceptance. Out of the 362 included participants, 278 were pregnant (PW) and 84 were lactating women (LW). The overall COVID-19 vaccine acceptance (immediate and delayed) level was substantially high (70.2%), with a significant difference between PW (76.6%) and LW (48.8%). Out of the 70.2% who agreed to receive the vaccine, 3.6% indicated immediate acceptance, and 66.6% indicated delayed acceptance. Only 13.3% of the participants indicated their acceptance of their physician’s vaccination recommendation during pregnancy or while lactating, and 62.2% were against it. Our results agreed with the recent studies that revealed that PW tended to have a high level of COVID-19 vaccine acceptance, and they were also inclined to resist professional recommendations because they predominantly preferred to delay their vaccination. The pregnancy trimester, education level, employment status, and previous live births were significant determinants for COVID-19 vaccine acceptance. The most commonly preferred vaccine type was mRNA-based vaccines, followed by viral vector-based and inactivated virus vaccines. The first top priority of PLW was vaccine safety for their children, followed by vaccine safety for the PLW and vaccine effectiveness. Regarding psychosocial predictors, media/social media, trust in the government, the pharmaceutical industry, and healthcare professionals, partners, and a positive risk-benefit ratio were significant promoters for COVID-19 vaccine acceptance. Findings from this study suggest that promotional interventions targeting PLW should use web platforms and focus on vaccine safety evidence, the expected benefits of vaccines and potential harms of the infection.

COVID-19 Vaccine Acceptance in Pregnant and Lactating Women and Mothers of Young Children in Poland

“…9 On the other hand, in a study conducted in the Czech Republic, high level of education was found to be a significant predictor of Covid-19 vaccine uptake among pregnant and lactating women. 20 The authors of the above study also emphasize the relationship between acceptance of COVID-19 vaccine and trimester of pregnancy. The study showed that women who were in the third trimester of pregnancy declared the highest level of acceptance of the vaccine.…”

“…11 However, according to alarming data from the NHS (National Health Service) in the UK, nearly one-fifth of the most critically ill COVID-19 patients are unvaccinated pregnant women. 20 …”

“…The study showed that women who were in the third trimester of pregnancy declared the highest level of acceptance of the vaccine. 20 This observation may be related to the fact that a number of vaccinations, including influenza (H1N1) vaccines, are recommended and widely accepted in the third trimester of pregnancy. The first and second trimester of pregnancy is presented as a critical period for organogenesis.…”

“…During this period, women avoid taking medications during pregnancy. 20 In observation reported by Sutton et al 18 where attitudes and beliefs regarding the acceptance of COVID-19 vaccination were examined in pregnant, lactating, and non-pregnant women. Pregnant as well as breastfeeding women were less likely to receive the vaccination compared to non-pregnant women.…”

Knowledge, attitude, perceptions, and concerns of pregnant and lactating women regarding COVID-19 vaccination: A cross-sectional survey of 313 participants from a tertiary care centre of North India

“…Vaccine hesitancy has different attributes in varied socio-cultural contexts which lie in a continuum between total acceptance to refusal. This is mostly associated with knowledge, attitude, perceptions, and concerns about the vaccine [ 2 ]. Besides, these factors also differ among the various population groups such as pregnant and lactating women.…”