Determinants of COVID-19 Vaccination Hesitancy among Romanian Pregnant Women.

Ioana Mihaela Citu,Bogdan Burlea,Cosmin Citu,Felix Bratosin,Madalin-Marius Margan,Samer Hosin,Daniel Malita,Emanuela Tudorache,Florin Gorun,Andrei Motoc,Oana Maria Gorun

doi:10.3390/vaccines10020275

Ioana Mihaela Citu, Bogdan Burlea + Show 9 more

Open Access

https://doi.org/10.3390/vaccines10020275

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Abstract

Universal COVID-19 immunization is seen as a critical approach for limiting the spread of SARS-CoV-2 and reducing the danger of new variations emerging in the general population, especially in pregnant women. The literature and accessible research data indicate that vaccination intentions vary greatly by country, with Romania ranking among the European nations with the lowest vaccination rates. Thus, we aimed to investigate the prevalence and extent of COVID-19 vaccine hesitancy among pregnant women in Romania and the factors influencing their decision. A cross-sectional study was conducted on pregnant women referred to the Obstetrics and Gynecology Clinic of the Timisoara Municipal Emergency Hospital in Romania. Participants were asked to complete the validated VAX scale about vaccine hesitancy and to report their willingness to receive a COVID-19 vaccine and their reasons for hesitancy. The group of 184 pregnant women who completed the survey recorded significantly more hesitant respondents than the non-pregnant group with 161 respondents (52.2% vs. 40.3%). They had significantly higher average scores in all VAX scale subsections, while 78.1% of them gave credits to social media for their COVID-19 vaccination decision, compared with 63.0% of non-pregnant women. The independent risk factors for hesitancy were determined as not being afraid of COVID-19 OR = 1.89, below-average income OR = 2.06, trusting social media rumors OR = 2.38, not believing in SARS-CoV-2 existence OR = 2.67, and being a vaccination non-believer OR = 3.15. We advocate for pregnant women to get vaccinated against COVID-19 and for the development of targeted campaigns to address the factors of hesitation. This research emphasizes the critical need for delivering the COVID-19 immunization to the whole community, including pregnant women who may have vaccine-related concerns.

Highlights

The coronavirus disease pandemic of 2019 (COVID-19) has claimed thousands of lives globally, creating public health issues, overburdening health systems, disrupting supply chains and the economy, and precipitating a mental health crisis [1]
The independent risk factors for hesitancy were determined as not being afraid of COVID-19 OR = 1.89, below-average income OR = 2.06, trusting social media rumors OR = 2.38, not believing in SARS-CoV-2 existence OR = 2.67, and being a vaccination non-believer OR = 3.15
Pregnant and postpartum women may be more prone than non-pregnant women to have a more severe course of COVID-19, and a relationship has been shown between COVID-19 and the risk of preterm and cesarean births [2]

Summary

Introduction

The coronavirus disease pandemic of 2019 (COVID-19) has claimed thousands of lives globally, creating public health issues, overburdening health systems, disrupting supply chains and the economy, and precipitating a mental health crisis [1]. Vaccination against infectious diseases is a very effective public health strategy that has been shown to significantly reduce global morbidity and death associated with infection [4]. Numerous vaccines against SARS-CoV-2 infection have been developed and authorized for general population usage, while adhering to all applicable laws. Pregnant women were not involved in the COVID-19 vaccine development trials, they have had access to these vaccinations since the FDA approved Pfizer/BioNTech immunization for pregnant women in early 2021, followed by the same reaction from the European Medicines

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