Provider Confidence in Counseling Preconception, Pregnant, and Postpartum Patients Regarding COVID-19 Vaccination

  1. Molly R. Siegel
  2. Kaitlyn E. James
  3. Elana Jaffe
  4. Michelle M. L’Heureux
  5. Anjali J. Kaimal
  6. Ilona T. Goldfarb

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Objective

To assess knowledge and confidence in COVID-19 vaccine counseling among practitioners who provide care to pregnant persons and to describe factors associated with confidence in counseling.

Study Design

A web-based anonymous survey was distributed via email to a cross-sectional convenience sample of OB/GYN, Primary Care, and Internal Medicine faculty at three hospitals in a single healthcare network in Massachusetts. Individual demographics and institution-specific variables were included in the survey along with questions assessing both attitudes toward COVID-19 illness in pregnancy as well as confidence in counseling regarding the use of the vaccine for pregnant patients.

Results

Almost all providers (151, 98.1%) reported already receiving or being scheduled to receive a COVID-19 vaccine, and a majority of providers (111, 72.1%) reported that they believe the benefits of the mRNA COVID-19 vaccine in pregnancy outweigh the risks. Forty-one (26.6%) reported feeling very confident in counseling patients who primarily speak English about the evidence for mRNA vaccination in pregnancy, and 36 (23%) reported feeling very confident in counseling patients who are not primarily English-speaking. Forty-three providers (28.1%) expressed strong confidence in their comfort talking to individuals with vaccine hesitancy based on historic and continued racism and systemic injustices. The sources that survey respondents most commonly used to find information regarding COVID-19 vaccination in pregnancy were the CDC (112, 74.2%), hospital-specific resources (94, 62.3%) and ACOG (82, 54.3%).

Conclusion

While providers reported high personal uptake of COVID-19 vaccination and felt that the benefits of vaccination outweigh the risks in pregnancy, less than one-third felt very confident in counseling pregnant patients about available evidence for mRNA vaccine safety in pregnancy. Ensuring that providers feel comfortable bridging the gap between their belief that the vaccine is beneficial for pregnant patients and their comfort with holding conversations with patients regarding vaccination is paramount in order to ensure equitable access to vaccines for pregnant patients.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2021.12.17.21267998: (What is this?)

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

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variableIndividual demographics and institution-specific variables were included in the survey along with questions assessing both attitudes toward COVID-19 illness in pregnancy as well as confidence in counseling regarding the use of the vaccine for preconception, pregnant, and lactating patients.
    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 this study was performed in the early phases of vaccination; as more data surrounding vaccination in pregnancy become available, providers may have shifting comfort with this counseling. Furthermore, participants who opted to complete the survey may have a different level of confidence with this counseling compared to the general provider population. In addition, this sample represents a group of predominantly non-Hispanic White clinicians with high baseline vaccine trust, as nearly all providers received the vaccine themselves, and most stated that they always recommend the influenza and Tdap vaccines to pregnant patients. Nearly half spoke a second language, which may increase their confidence in counseling non-English speaking patients. As such, the confidence of this group may overrepresent the confidence of all clinicians who engage in vaccine counseling with pregnant patients. Finally, this study was conducted prior to the authorization of the vaccine developed by Janssen, which does not use an mRNA platform.

    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.

  2. Version published to 10.1101/2021.12.17.21267998v1 on medRxiv