Primary Submission Category: Reproductive health
COVID-19 Vaccine Hesitancy in Pregnancy: A Scoping Literature Review
Authors: Alyssa Kretz Imaima Casubhoy Heang-Lee Tan Rosemary Morgan
Presenting Author: Alyssa Kretz*
Pregnant people are at risk of severe COVID-19 infection but are more likely than non-pregnant people to express COVID-19 vaccine hesitancy, placing them and their fetus at risk. This study aims to understand reasons for COVID-19 vaccine hesitancy in pregnancy to improve messaging and uptake of the vaccine in this population.
Using PubMed, Embase, CINAHL, and Scopus, we conducted a scoping literature review to explore reasons for COVID-19 vaccine hesitancy among pregnant people. Studies included were published in English between 2019-2022 and focused on reasons for COVID-19 vaccine hesitancy or attitudes toward COVID-19 vaccination among pregnant people. Two independent reviewers screened citations and extracted data. Between February-April 2023, we will also recruit 35 pregnant people from different racial/ethnic groups with COVID-19 vaccine hesitancy to participate in interviews regarding their experience.
After reviewing 1144 citations, 44 studies were included with a total of 40,935 participants across 39 countries. Reasons for vaccine hesitancy included fear of effects on the baby and themselves and lack of data on vaccine use in pregnancy. Most respondents were not opposed to receiving other vaccines. Recommendations for improving COVID-19 vaccine uptake included dissemination of pregnancy-specific information, inclusion of pregnant people in vaccine clinical trials, and improved educational materials and communication training for providers. Preliminary qualitative results confirm that fear of effects for the baby and themselves were motivators of pregnant people’s decision to not get vaccinated.
Pregnant people may be hesitant about COVID-19 vaccination due to fear of effects on their unborn baby. It is important to include pregnant people in vaccine clinical trials and equip providers with tools to counsel their pregnant patients. Future studies should focus on developing COVID-19 vaccination campaigns targeted toward the concerns of pregnant people.