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Am J Perinatol 2022; 39(01): 075-083
DOI: 10.1055/s-0041-1735878
Original Article

Attitudes Toward COVID-19 Illness and COVID-19 Vaccination among Pregnant Women: A Cross-Sectional Multicenter Study during August–December 2020

Ashley N. Battarbee 
1   Center for Women's Reproductive Health and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, Birmingham, Alabama
,
Melissa S. Stockwell
2   Department of Pediatrics, Division of Child and Adolescent Health, Columbia University Irving Medical Center, New York, New York
3   Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
4   Department of Obstetrics and Gynecology, New York-Presbyterian Hospital, New York, New York
,
Michael Varner 
5   Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah
,
Gabriella Newes-Adeyi
6   Abt Associates, Bethesda, Maryland
,
Michael Daugherty
7   Centers for Disease Control and Prevention, Atlanta, Georgia
,
Cynthia Gyamfi-Bannerman
4   Department of Obstetrics and Gynecology, New York-Presbyterian Hospital, New York, New York
8   Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Columbia University Irving Medical Center, New York, New York
,
Alan T. Tita
1   Center for Women's Reproductive Health and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, Birmingham, Alabama
,
Kelly Vorwaller
5   Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah
,
Celibell Vargas
2   Department of Pediatrics, Division of Child and Adolescent Health, Columbia University Irving Medical Center, New York, New York
,
Akila Subramaniam
1   Center for Women's Reproductive Health and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, Birmingham, Alabama
,
Lawrence Reichle
6   Abt Associates, Bethesda, Maryland
,
Romeo R. Galang 
7   Centers for Disease Control and Prevention, Atlanta, Georgia
,
Emily Powers
5   Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah
,
Miriam Lucca-Susana
4   Department of Obstetrics and Gynecology, New York-Presbyterian Hospital, New York, New York
8   Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Columbia University Irving Medical Center, New York, New York
,
Mickey Parks
1   Center for Women's Reproductive Health and Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, Birmingham, Alabama
,
Tiffany J. Chen
7   Centers for Disease Control and Prevention, Atlanta, Georgia
,
Hilda Razzaghi
7   Centers for Disease Control and Prevention, Atlanta, Georgia
,
Fatimah S. Dawood
7   Centers for Disease Control and Prevention, Atlanta, Georgia
› Author Affiliations Funding This study was funded by the U.S. Centers for Disease Control and Prevention through Contract # 75D30120C08150 with Abt Associates.
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Abstract

Objective The aim of the study was to evaluate pregnant women's attitudes toward COVID-19 illness and vaccination and identify factors associated with vaccine acceptability.

Study Design This was a cross-sectional survey among pregnant women enrolled in a prospective COVID-19 cohort study in Salt Lake City, UT, Birmingham, AL, and New York, NY, from August 9 to December 10, 2020. Women were eligible if they were 18 to 50 years old and <28 weeks of gestation. Upon enrollment, women completed surveys regarding concerns about COVID-19 illness and likelihood of getting COVID-19 vaccine if one were available during pregnancy. Vaccine acceptability was defined as a response of “very likely” or “somewhat likely” on a 4-point Likert scale. Factors associated with vaccine acceptability were assessed with multivariable logistic regression.

Results Of 939 pregnant women eligible for the main cohort study, 915 (97%) consented to participate. Among these 915 women, 39% self-identified as White, 23% Black, 33% Hispanic, and 4% Other. Sixty-two percent received an influenza vaccine last season. Seventy-two percent worried about getting sick with COVID-19. If they were to get sick, 92% worried about harm to their pregnancy and 80% about harm to themselves. Only 41% reported they would get a vaccine. Of women who were unlikely to get vaccinated, the most frequently cited concern was vaccine safety for their pregnancy (82%). Non-Hispanic Black and Hispanic women had lower odds of accepting a vaccine compared with non-Hispanic White women (adjusted odds ratios [aOR] 0.4, 95% CI 0.2–0.6 for both). Receipt of influenza vaccine during the previous season was associated with higher odds of vaccine acceptability (aOR 2.1, 95% CI 1.5–3.0).

Conclusion Although most pregnant women worried about COVID-19 illness, <50% were willing to get vaccinated during pregnancy. Racial and ethnic disparities in plans to accept COVID-19 vaccine highlight the need to prioritize strategies to address perceived barriers among groups at high risk for COVID-19.

Key Points

  • Less than half of pregnant patients stated they would get a COVID-19 vaccine.

  • Protecting their baby was the most common reason for acceptance and refusal of the COVID-19 vaccine.

  • Patients of minority race/ethnicity and those without prior influenza vaccination were less likely to accept the COVID-19 vaccine.

Keywords

pregnancy - COVID-19 - vaccine - race

Note

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry, U.S. Department of Health and Human Services.




Publication History

Received: 01 February 2021

Accepted: 09 August 2021

Article published online:
01 October 2021

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