Factors of COVID-19 vaccine hesitancy during pregnancy: a cross-sectional study

Abstract

A pregnant patient’s attitude toward the COVID-19 vaccine could determine their decision to immunize during pregnancy, which has been shown to confer protection for them and also for the infant. We seek to characterize the attitudes and concerns of pregnant patients towards the COVID-19 vaccine to enable tailoring of methods for increased vaccination uptake. Between April and June 2021, pregnant patients at 11-28 weeks were approached to complete the cross-sectional, web-based questionnaire. The primary survey focus was a 10-point Likert scale of the likelihood to receive the COVID-19 vaccine in pregnancy, compressed into “high” (7-10), “medium” (4-6) or “low” (0-3) likelihood groups. Chi-square or fisher’s exact test was used to determine differences in responses based on the likelihood of vaccine receipt for survey items measuring basic demographics, social attitudes, informational trust, decisional-conflict and vaccine beliefs. 383 pregnant patients were approached with 280 consented (73.4%). 247 participants answered all survey items, largely split between low (49.4%) and high (41.3%) likelihoods with medium composing 9.3% (Table 1). Participants reporting low likelihood of receiving the COVID-19 vaccine had higher uncertainty about vaccine’s long-term effect and benefits (p< 0.001) (Figure 1-C). Participants in the high likelihood group identified physicians to be the main source of COVID-19 vaccine information. In contrast, participants in the low likelihood group identified TV and social media to be the major sources of vaccine information (p< 0.01, Figure 1-A). When asked what would reduce vaccine hesitancy, two leading answers in the high likelihood group were” physician recommendation” (37.6%) and “published data” (29.9%) compared to that in the low-likelihood group of “published data” (43.5%) and “a pregnant friend who got vaccinated” (26.1%, Figure 1-B). In pregnant patients with high vaccine hesitancy, the survey helped to identify alternative methods to physician recommendation that can be used to increase COVID-19 vaccine uptake.View Large Image Figure ViewerDownload Hi-res image Download (PPT)