COVID-19 vaccine acceptance and coverage among pregnant persons in the United States

Annette K. Regan · Marcianna Nosek · Pallavi Aytha Swathi · Ning Yan Gu

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Vaccine Coverage and Hesitancy SARS-CoV-2 and COVID-19 Research COVID-19 Impact on Reproduction

Abstract

Pregnant persons are at higher risk of severe COVID-19. Although vaccination is recommended, COVID-19 vaccination rates are lower among pregnant persons compared to the non-pregnant population. We aimed to evaluate acceptance of any dose of COVID-19 vaccine during pregnancy. A national online cross-sectional survey of US adults who were pregnant between December 2020 and July 2021 was used to measure COVID-19 vaccine behaviors, attitudes, and beliefs. Post-stratification weighting was used to ensure representativeness to the US population. Marginal log-binomial models were used to estimate adjusted prevalence ratios (aPR) of COVID-19 vaccine acceptance, accounting for sociodemographic factors. Of 5,660 who responded to survey advertisements, 2,213 met eligibility criteria and completed the survey; 55.4% of respondents received or planned to receive COVID-19 vaccine prior to or during pregnancy, 27.0% planned to vaccinate after pregnancy, 8.8% were unsure and 8.7% had no plans to vaccinate. Individuals were more likely to receive or plan to receive COVID-19 vaccine if they had group prenatal care (aPR 1.57; 95% CI 1.40, 1.75), were employed in a workplace with a policy recommending vaccination (aPR 1.15; 95% CI 1.06, 1.26), and believed COVID-19 vaccines are safe (aPR 2.86; 95% CI 2.49, 3.29). Pregnant persons who were recommended COVID-19 vaccination by their healthcare provider less commonly reported concerns about vaccine safety (35.5% vs 55.9%) and were more likely to accept COVID-19 vaccines (aPR 1.52; 95% CI 1.31, 1.76). COVID-19 vaccine acceptance during pregnancy is not universal and public health intervention will be needed to continue to increase vaccine coverage.

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20122013 NCHS Urban-Rural Classification Scheme for Counties.2021COVID-19 vaccine acceptance among pregnant women and mothers of young children: results of a survey in 16 countries 2015Understanding factors influencing vaccination acceptance during pregnancy globally: A literature review 2021COVID-19 Vaccination Coverage Among Pregnant Women During Pregnancy — Eight Integrated Health Care Organizations, United States, December 14, 2020–May 8, 2021 2021COVID-19 vaccine acceptance among pregnant, breastfeeding, and nonpregnant reproductive-aged women 2021Attitudes Toward COVID-19 Illness and COVID-19 Vaccination among Pregnant Women: A Cross-Sectional Multicenter Study during August–December 2020 2016Predictors of maternal vaccination in the United States: An integrative review of the literature 2014Antenatal care provider's advice is the key determinant of influenza vaccination uptake in pregnant women

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2022COVID-19 Vaccination and Related Determinants of Hesitancy among Pregnant Women: A Systematic Review and Meta-Analysis

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