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Understanding COVID-19 vaccine uptake during pregnancy: 'Hesitance', knowledge, and evidence-based decision-making.
Vaccine. 2022 04 26; 40(19):2755-2760.V

Abstract

BACKGROUND

A key mitigation strategy to the COVID-19 pandemic has been the development and roll-out of vaccines. However, pregnant and lactating people were not included in initial vaccine trials and this population is hesitant to receive the vaccine, despite contrary recommendations from the American College of Obstetrics and Gynecology and the Centers for Disease Control and Prevention. Understanding the reasons behind this hesitancy is vital to promote vaccine uptake.

METHODS

We surveyed pregnant people in California from December 2020 to January 2021 (n = 387) to describe cognitions and decision-making regarding COVID-19 vaccination. Using descriptive, regression-based analyses, we examined rates of planned uptake and reasoning among individuals who reported COVID-19 vaccine hesitancy.

RESULTS

Overall, the pregnant Californians that we surveyed were aware of the COVID-19 vaccines. Of 387 participants, 43% reported planning to get the vaccine as soon as possible. The remaining 57% were hesitant: 27% responded that they would not receive the vaccine. Some demographic features did predict more COVID-19 vaccine hesitancy, particularly younger age (AOR = 0.95, p = 0.025) and living in a less urban context (AOR = 0.80, p = 0.041). Essential worker status also was associated with vaccine hesitancy. Having had, or intending to have, a flu vaccine was negatively associated with COVID-19 vaccine hesitancy (p < 0.001). The most commonly reported reason for COVID-19 vaccine hesitancy was "I don't know enough about the vaccine." Low levels of self-reported knowledge were highly predictive of hesitancy.

CONCLUSIONS

Terms like "vaccine hesitance" and "anti-vax" do not adequately characterize decisions regarding delaying COVID-19 vaccination. Rather, these decisions are largely based on the lack of knowledge about the impacts of vaccination on pregnancy, fetal development, and later child wellbeing. This lack of knowledge should be countered by conversations between individual healthcare providers and their pregnant patients, and better inclusion of pregnant people and children in vaccine trials.

Links

PMC Free PDF

Authors+Show Affiliations

Simmons LA
University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States. Electronic address: lasimm@ucdavis.edu.
Whipps MDM
University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States.
Phipps JE
University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States.
Satish NS
University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States.
Swamy GK
Duke University School of Medicine, Department of Obstetrics and Gynecology, 40 Duke Medicine Circle, Durham, NC 27705, United States.

MeSH

COVID-19COVID-19 VaccinesChildCross-Sectional StudiesFemaleHumansInfluenza VaccinesLactationPandemicsPregnancySARS-CoV-2United StatesVaccination

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

35361501

Citation

Simmons, Leigh Ann, et al. "Understanding COVID-19 Vaccine Uptake During Pregnancy: 'Hesitance', Knowledge, and Evidence-based Decision-making." Vaccine, vol. 40, no. 19, 2022, pp. 2755-2760.
Simmons LA, Whipps MDM, Phipps JE, et al. Understanding COVID-19 vaccine uptake during pregnancy: 'Hesitance', knowledge, and evidence-based decision-making. Vaccine. 2022;40(19):2755-2760.
Simmons, L. A., Whipps, M. D. M., Phipps, J. E., Satish, N. S., & Swamy, G. K. (2022). Understanding COVID-19 vaccine uptake during pregnancy: 'Hesitance', knowledge, and evidence-based decision-making. Vaccine, 40(19), 2755-2760. https://doi.org/10.1016/j.vaccine.2022.03.044
Simmons LA, et al. Understanding COVID-19 Vaccine Uptake During Pregnancy: 'Hesitance', Knowledge, and Evidence-based Decision-making. Vaccine. 2022 04 26;40(19):2755-2760. PubMed PMID: 35361501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Understanding COVID-19 vaccine uptake during pregnancy: 'Hesitance', knowledge, and evidence-based decision-making. AU - Simmons,Leigh Ann, AU - Whipps,Mackenzie D M, AU - Phipps,Jennifer E, AU - Satish,Nikita S, AU - Swamy,Geeta K, Y1 - 2022/03/25/ PY - 2021/06/15/received PY - 2022/03/02/revised PY - 2022/03/18/accepted PY - 2022/4/2/pubmed PY - 2022/4/19/medline PY - 2022/4/1/entrez KW - COVID-19 KW - California KW - Health decision-making KW - Pregnancy KW - SARS-CoV-2 KW - Vaccination KW - Vaccine hesitancy SP - 2755 EP - 2760 JF - Vaccine JO - Vaccine VL - 40 IS - 19 N2 - BACKGROUND: A key mitigation strategy to the COVID-19 pandemic has been the development and roll-out of vaccines. However, pregnant and lactating people were not included in initial vaccine trials and this population is hesitant to receive the vaccine, despite contrary recommendations from the American College of Obstetrics and Gynecology and the Centers for Disease Control and Prevention. Understanding the reasons behind this hesitancy is vital to promote vaccine uptake. METHODS: We surveyed pregnant people in California from December 2020 to January 2021 (n = 387) to describe cognitions and decision-making regarding COVID-19 vaccination. Using descriptive, regression-based analyses, we examined rates of planned uptake and reasoning among individuals who reported COVID-19 vaccine hesitancy. RESULTS: Overall, the pregnant Californians that we surveyed were aware of the COVID-19 vaccines. Of 387 participants, 43% reported planning to get the vaccine as soon as possible. The remaining 57% were hesitant: 27% responded that they would not receive the vaccine. Some demographic features did predict more COVID-19 vaccine hesitancy, particularly younger age (AOR = 0.95, p = 0.025) and living in a less urban context (AOR = 0.80, p = 0.041). Essential worker status also was associated with vaccine hesitancy. Having had, or intending to have, a flu vaccine was negatively associated with COVID-19 vaccine hesitancy (p < 0.001). The most commonly reported reason for COVID-19 vaccine hesitancy was "I don't know enough about the vaccine." Low levels of self-reported knowledge were highly predictive of hesitancy. CONCLUSIONS: Terms like "vaccine hesitance" and "anti-vax" do not adequately characterize decisions regarding delaying COVID-19 vaccination. Rather, these decisions are largely based on the lack of knowledge about the impacts of vaccination on pregnancy, fetal development, and later child wellbeing. This lack of knowledge should be countered by conversations between individual healthcare providers and their pregnant patients, and better inclusion of pregnant people and children in vaccine trials. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/35361501/Understanding_COVID_19_vaccine_uptake_during_pregnancy:_'Hesitance'_knowledge_and_evidence_based_decision_making_ DB - PRIME DP - Unbound Medicine ER -