Perceptions and Attitudes toward COVID-19 Vaccination among Pregnant and Postpartum Individuals

  1. Molly R. Siegel
  2. Mario I. Lumbreras-Marquez
  3. Kaitlyn James
  4. Brandon R. McBay
  5. Kathryn J. Gray
  6. Julianna Schantz-Dunn
  7. Khady Diouf
  8. Ilona T. Goldfarb

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Abstract

Objective This study aimed to characterize attitudes toward novel coronavirus disease 2019 (COVID-19) vaccination and to evaluate factors associated with vaccine uptake among pregnant individuals.

Study Design An anonymous survey was distributed to a convenience sample of pregnant individuals receiving prenatal care at two large urban academic hospitals in a single health care network in Massachusetts. Individual demographic variables were included in the survey along with questions assessing attitudes toward COVID-19 and vaccination in pregnancy. Data were analyzed using parametric or nonparametric tests when appropriate, and associated odds ratios (OR) were calculated via univariable logistic regression.

Results There were 684 surveys distributed, and 477 pregnant and postpartum individuals completed the survey, for a response rate of 69.7%. Overall, 233 (49.3%) had received or were scheduled to receive a COVID-19 vaccine. Age, White race, non-Hispanic or Latinx ethnicity, working from home, and typical receipt of the influenza vaccine were associated with COVID-19 vaccination. Further, 276 respondents (58.4%) reported that their provider recommended the COVID-19 vaccine in pregnancy; these participants were more likely to have received a vaccine (OR = 5.82, 95% confidence interval [CI]: 3.68–9.26, p < 0.005). Vaccinated individuals were less likely to be worried about the effects of the vaccine on themselves (OR = 0.18, 95% CI: 0.12–0.27, p < 0.005) or their developing babies (OR = 0.17, 95% CI: 0.11–0.26, p < 0.005). Unvaccinated individuals were less likely to report that it is easy to schedule a COVID-19 vaccine (OR = 0.56, 95% CI: 0.34–0.93, p = 0.02), to travel to receive a vaccine (OR = 0.19, 95% CI: 0.10–0.36, p < 0.005), and to miss work to receive a vaccine (OR = 0.30, 95% CI: 0.18–0.48, p < 0.005).

Conclusion Strategies are needed to improve patient education regarding vaccine side effects and safety in pregnancy. Policy changes should focus on making it feasible for patients to schedule a vaccine and miss work without loss of pay to get vaccinated.

Key Points

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  1. Version published to 10.1055/a-1877-5880
  2. ScreenIT

    SciScore for 10.1101/2021.12.17.21267997: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variableParticipants: Survey participants were from a cross-sectional convenience sample of pregnant and postpartum individuals aged 18 or older receiving prenatal care at two large urban academic hospitals and three affiliated community health centers in a single healthcare network in Massachusetts from June to August 2021.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations include that it was conducted when the CDC and ACOG guidance was to offer, but not necessarily recommend, vaccination to pregnant patients. Acceptance of vaccination may be higher now that these organizations have provided stronger guidance regarding vaccination in pregnancy. Furthermore, the survey did not ask participants to differentiate their responses based on receipt or consideration of mRNA or viral vector vaccine, and it is possible that participants may have had different concerns depending on vaccine type.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.12.17.21267997v1 on medRxiv