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. 2024 Apr 1;7(4):e245479.
doi: 10.1001/jamanetworkopen.2024.5479.

Attitudes Toward COVID-19 Vaccines Among Pregnant and Recently Pregnant Individuals

Joshua T B Williams  1   2 , Kate Kurlandsky  1 , Kristin Breslin  1 , M Joshua Durfee  1 , Amy Stein  1 , Laura Hurley  1 , Jo Ann Shoup  3 , Liza M Reifler  3 , Matthew F Daley  2   3 , Bruno J Lewin  4 , Kristin Goddard  5 , Michelle L Henninger  6 , Jennifer C Nelson  7 , Gabriela Vazquez-Benitez  8 , Kayla E Hanson  9 , Candace C Fuller  10 , Eric S Weintraub  11 , Michael M McNeil  11 , Simon J Hambidge  1   2
Affiliations

Attitudes Toward COVID-19 Vaccines Among Pregnant and Recently Pregnant Individuals

Joshua T B Williams et al. JAMA Netw Open. .

Abstract

Importance: Pregnant people and infants are at high risk of severe COVID-19 outcomes. Understanding changes in attitudes toward COVID-19 vaccines among pregnant and recently pregnant people is important for public health messaging.

Objective: To assess attitudinal trends regarding COVID-19 vaccines by (1) vaccination status and (2) race, ethnicity, and language among samples of pregnant and recently pregnant Vaccine Safety Datalink (VSD) members from 2021 to 2023.

Design, setting, and participants: This cross-sectional surveye study included pregnant or recently pregnant members of the VSD, a collaboration of 13 health care systems and the US Centers for Disease Control and Prevention. Unvaccinated, non-Hispanic Black, and Spanish-speaking members were oversampled. Wave 1 took place from October 2021 to February 2022, and wave 2 took place from November 2022 to February 2023. Data were analyzed from May 2022 to September 2023.

Exposures: Self-reported or electronic health record (EHR)-derived race, ethnicity, and preferred language.

Main outcomes and measures: Self-reported vaccination status and attitudes toward monovalent (wave 1) or bivalent Omicron booster (wave 2) COVID-19 vaccines. Sample- and response-weighted analyses assessed attitudes by vaccination status and 3 race, ethnicity, and language groupings of interest.

Results: There were 1227 respondents; all identified as female, the mean (SD) age was 31.7 (5.6) years, 356 (29.0%) identified as Black race, 555 (45.2%) identified as Hispanic ethnicity, and 445 (36.3%) preferred the Spanish language. Response rates were 43.5% for wave 1 (652 of 1500 individuals sampled) and 39.5% for wave 2 (575 of 1456 individuals sampled). Respondents were more likely than nonrespondents to be White, non-Hispanic, and vaccinated per EHR. Overall, 76.8% (95% CI, 71.5%-82.2%) reported 1 or more COVID-19 vaccinations; Spanish-speaking Hispanic respondents had the highest weighted proportion of respondents with 1 or more vaccination. Weighted estimates of somewhat or strongly agreeing that COVID-19 vaccines are safe decreased from wave 1 to 2 for respondents who reported 1 or more vaccinations (76% vs 50%; χ21 = 7.8; P < .001), non-Hispanic White respondents (72% vs 43%; χ21 = 5.4; P = .02), and Spanish-speaking Hispanic respondents (76% vs 53%; χ21 = 22.8; P = .002).

Conclusions and relevance: Decreasing confidence in COVID-19 vaccine safety in a large, diverse pregnant and recently pregnant insured population is a public health concern.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Reifler reported a family member owning stock in Johnson and Johnson. Dr Daley reported serving as a voting member of the Advisory Committee on Immunization Practices, which provides advice to the Centers for Disease Control and Prevention (CDC) regarding vaccine policy matters. Dr Nelson reported receiving personal fees from Harvard Pilgrim Health Care for statistical consulting services outside the submitted work. Dr Vazquez-Benitez reported receiving grants from Abvvie Research and Sanofi Research outside the submitted work. Dr Fuller reported that her institution has received funding for research from Pfizer and Johnson and Johnson, which is unrelated to this work. No other disclosures were reported.

Figures

Figure.
Figure.. Timeline of Survey Waves 1 and 2 in Relation to the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists (ACOG) COVID-19 Vaccine Emergency Use Authorizations (EUAs) and Subsequent Recommendations for Monovalent and Bivalent (Omicron) Booster COVID-19 Vaccines in Pregnant Individuals
Recommendations directly from CDC; regarding bivalent (Omicron) booster, see CDC, 2022. Recommendations directly from ACOG; regarding bivalent (Omicron) booster, see ACOG, 2022.
See this image and copyright information in PMC

References

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