The Approach of Pregnant Women to Vaccination Based on a COVID-19 Systematic Review

Abstract

Background and Objectives: Pregnant women are more likely to develop a more severe course of COVID-19 than their non-pregnant peers. There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnant women. The aim of this study is to conduct a systematic review concerning the approach of pregnant women towards vaccination against COVID-19, with particular regard to determinants of vaccination acceptance. Materials and Methods: Articles were reviewed in which the aim was to evaluate—via a survey or questionnaire—the acceptance and decision to undergo vaccination against COVID-19. The articles were subjected to review according to recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Results: In various studies, the percentage of pregnant women accepting the COVID-19 vaccine was between 29.7% and 77.4%. The strongest factors co-existing with the acceptance of the COVID-19 vaccination in pregnancy were trust in the importance and effectiveness of the vaccine, explicit communication about the safety of COVID-19 vaccines for pregnant women, acceptance of other vaccinations such as those for influenza, belief in the importance of vaccines/mass vaccination in one’s own country, anxiety about COVID-19, trust in public health agencies/health science, as well as compliance to mask guidelines. The remaining factors were older age, higher education, and socioeconomic status. Conclusions: This review allowed us to show that geographic factors (Asian, South American countries) and pandemic factors (different threats and risks from infection) significantly influence the acceptance of vaccines. The most significant factors affecting acceptance are those related to public awareness of the risk of infection, vaccine safety, and the way in which reliable information about the need and safety of vaccines is provided. Professional and reliable patient information by obstetricians and qualified medical personnel would significantly increase the level of confidence in vaccination against COVID-19.

A comparison of COVID‐19 vaccination status among pregnant Israeli Jewish and Arab women and psychological distress among the Arab women

“…Furthermore, lower economic status and physical health and already being a mother were related to higher psychological distress among the Arab women. The findings regarding economic status and physical health are consistent with the results of previous studies (Gur et al, 2020 ; Januszek et al, 2021 ; Matsushima & Horiguchi, 2020 ) and may indicate that less favorable background characteristics, which put pregnant women at greater risk for psychological distress even in routine times (Goletzke et al, 2017 ; Koleva et al, 2011 ), are even more telling after prolonged coping with a pandemic that has serious implications for their health, social, and economic status. In the case of mothers, the need to care for their children while contending with the pandemic and their pregnancy concurrently may place enormous demands on them and exhaust their ability to cope well with the situation.…”

“…However, it might indicate a degree of mistrust in the vaccine in this population, so that those who had already recovered from COVID‐19 felt more immune to the virus. Another possibility is that anxiety about COVID‐19 was a motivating factor to obtain vaccination against COVID‐19, as has been suggested in a systematic review concerning the association between COVID‐19 anxiety of the extent of compliance to be vaccinated against it among pregnant women (Januszek et al, 2021 ). As this is the first study to explore this issue, future studies are warranted to deepen our understanding of the psychological mechanisms underlying pregnant women's fears of infection.…”

Influenza and Pertussis Maternal Vaccination Coverage and Influencing Factors in Spain: A Study Based on Primary Care Records Registry

“…However, in England, a large reduction in vaccination rates of up to 43.7% was recorded [ 31 ]. The variability of acceptance of the vaccine against COVID-19 in pregnant women is also wide, between 29.7% and 77.4%, geographically dependent, and related to acceptance of the influenza vaccine [ 32 ]. These results suggest that promoting MV against COVID-19 together with influenza may be beneficial for increasing vaccination coverage of the latter.…”

The Benefits of Vaccination against SARS-CoV-2 during Pregnancy in Favor of the Mother/Newborn Dyad

“…In a study conducted by Skjefte M et al, the level of vaccine acceptability amongst pregnant women was around 52% [14]. In a systematic review led by Januszek S et al, over 33 studies that appealed the acceptability of SARS-CoV-2 vaccination for pregnant or lactating individuals was between 29.7 and 77.4% [15]. In our country, a study conducted by Citu IM et al concerning vaccine acceptability for pregnant women observed a hesitancy of 52.5% vs. 40.3% for non-pregnant individuals [16].…”