Women’s views on accepting COVID-19 vaccination during and after pregnancy, and for their babies: A multi-methods study in the UK

Abstract

Background: COVID-19 vaccines are the cornerstone of the pandemic response and now advised for pregnant women in the United Kingdom (UK) however COVID-19 vaccine acceptance among pregnant women is unknown. Methods: An online survey and semi-structured interviews were used to investigate pregnant women's views on COVID-19 vaccine acceptability for themselves when pregnant, not pregnant and for their babies. 1,181 women, aged over 16 years, who had been pregnant since 23rd March 2020, were surveyed between 3rd August - 11th October 2020. Ten women were interviewed. Results: The majority of women surveyed (81.2%) reported that they would 'definitely' or were 'leaning towards' accepting a COVID-19 vaccine when not pregnant. COVID-19 vaccine acceptance was significantly lower during pregnancy (62.1%, p<0.005) and for their babies (69.9%, p<0.005). Ethnic minority women were twice as likely to reject a COVID-19 vaccine for themselves when not pregnant, pregnant and for their babies compared to women from White ethnic groups (p<0.005). Women from lower-income households, aged under 25-years, and from some geographic regions were more likely to reject a COVID-19 vaccine when not pregnant, pregnant and for their babies. Multivariate analysis revealed that income and ethnicity were the main drivers of the observed age and regional differences. Women unvaccinated against pertussis in pregnancy were over four times more likely to reject COVID-19 vaccines when not pregnant, pregnant and for their babies. Thematic analysis of the survey freetext responses and interviews found safety concerns about COVID-19 vaccines were common though wider mistrust in vaccines was also expressed. Trust in vaccines and the health system were also reasons women gave for accepting COVID-19 vaccines. Conclusion: Safety information on COVID-19 vaccines must be clearly communicated to pregnant women to provide reassurance and facilitate informed pregnancy vaccine decisions. Targeted interventions to promote COVID-19 vaccine uptake among ethnic minority and lower-income women may be needed.

COVID-19 vaccination during pregnancy: coverage and safety

“…Our results showed that pregnant women of Afro-Caribbean ethnicity were less likely to receive the vaccine; this is consistent with recent questionnaire data both in pregnancy and outside of pregnancy. 8 However, people from ethnic minority groups are more likely to suffer from severe COVID-19, with increased risk of hospitalization, higher ICU admissions, and higher death rates in those of South Asian ethnicity in the United Kingdom. 19 Of note, ethnicity did not seem like an indication for COVID-19 vaccination in pregnancy until March 24, 2021, 12 emphasizing the importance of tailoring counseling to individual pregnant women to encourage uptake.…”

“…Concerns were particularly related to long-term effects and about the speed at which vaccines were developed and tested. 8 There is additional evidence that pregnant women in the United Kingdom have concerns about vaccination in general. Although the United Kingdom has an extensive antenatal immunization program, with a routine offer of vaccination against pertussis, diphtheria, tetanus, polio, and seasonal influenza, 24 a multicenter questionnaire study into vaccine hesitancy for influenza and pertussis vaccination in pregnancy found that, most commonly, vaccination was declined for fear of adverse fetal effects.…”

“…Pregnant women have been reluctant to receive COVID-19 vaccination 8 and guidance for healthcare professionals has not been consistent. Some guidelines initially recommended against routine COVID-19 vaccination in pregnancy but pivoted as safety data accumulated (eg, the United Kingdom Joint Committee on Vaccination and Immunisation [JCVI] 9 ), whereas others recommended routine vaccination from the start (eg, the International Federation of Gynecology and Obstetrics).…”

Aceptación de la de vacunación contra la COVID-19 en mujeres peruanas embarazadas: Actitudes y factores asociados

“…No obstante, es importante mencionar que en algunos estudios se ha encontrado que las mujeres embarazadas tenían menos predisposición a vacunarse que las mujeres no gestantes (Skirrow et al, 2021;Skjefte et al, 2021;Sutton et al, 2021). Esto probablemente se deba a que las mujeres gestantes no solo se preocupan de los efectos adversos de las vacunas en ellas, sino de la seguridad y el bienestar del nonato; siendo esto uno de los principales motivos por los que las mujeres gestantes tomarían la decisión de vacunarse o no (Geoghegan et al, 2021).…”

“…Por otro lado, una de las razones por las que no se vacunarían fue porque desconfiaban del sistema de salud, siendo esta desconfianza mayor en las gestantes. Otros estudios han reportado resultados similares, donde la confianza en las instituciones de salud y la información recibida por estas fueron importantes predictores para que las mujeres gestantes acepten la vacunación contra la COVID-19 (Levy et al, 2021;Skirrow et al, 2021;Skjefte et al, 2021). Este comportamiento también se ha visto en la población en general, en un estudio realizado en 19 países se encontró que, si una persona tenía mayor confianza en su gobierno, entonces era más probable que tuviera una actitud positiva hacia la vacunación, o también si algún miembro del personal de salud se lo recomendaba (Lazarus et al, 2021).…”