womens views on accepting covid 19 vaccination during and after pregnancy and for CORD-Papers-2022-06-02 (Version 1)

Title: Womens views on accepting COVID-19 vaccination during and after pregnancy and for their babies: a multi-methods study in the UK
Abstract: BACKGROUND: COVID-19 vaccines are advised for pregnant women in the United Kingdom (UK) however COVID-19 vaccine uptake among pregnant women is inadequate. METHODS: An online survey and semi-structured interviews were used to investigate pregnant womens views on COVID-19 vaccine acceptability for themselves when pregnant not pregnant and for their babies. One thousand one hundred eighty-one women aged over 16 years who had been pregnant since 23rd March 2020 were surveyed between 3rd August11th October 2020. Ten women were interviewed. RESULTS: The majority of women surveyed (81.2%) reported that they would definitely or were leaning towards accepting a COVID-19 vaccine when not pregnant. COVID-19 vaccine acceptance was significantly lower during pregnancy (62.1% p < 0.005) and for their babies (69.9% p < 0.005). Ethnic minority women were twice as likely to reject a COVID-19 vaccine for themselves when not pregnant pregnant and for their babies compared to women from White ethnic groups (p < 0.005). Women from lower-income households aged under 25-years and from some geographic regions were more likely to reject a COVID-19 vaccine when not pregnant pregnant and for their babies. Multivariate analysis revealed that income and ethnicity were the main drivers of the observed age and regional differences. Women unvaccinated against pertussis in pregnancy were over four times more likely to reject COVID-19 vaccines when not pregnant pregnant and for their babies. Thematic analysis of the survey freetext responses and interviews found safety concerns about COVID-19 vaccines were common though wider mistrust in vaccines was also expressed. Trust in vaccines and the health system were also reasons women gave for accepting COVID-19 vaccines. CONCLUSION: Safety information on COVID-19 vaccines must be clearly communicated to pregnant women to provide reassurance and facilitate informed pregnancy vaccine decisions. Targeted interventions to promote COVID-19 vaccine uptake among ethnic minority and lower-income women may be needed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-021-04321-3.
Published: 2022-01-14
Journal: BMC Pregnancy Childbirth
DOI: 10.1186/s12884-021-04321-3
DOI_URL: http://doi.org/10.1186/s12884-021-04321-3
Author Name: Skirrow Helen
Author link: https://covid19-data.nist.gov/pid/rest/local/author/skirrow_helen
Author Name: Barnett Sara
Author link: https://covid19-data.nist.gov/pid/rest/local/author/barnett_sara
Author Name: Bell Sadie
Author link: https://covid19-data.nist.gov/pid/rest/local/author/bell_sadie
Author Name: Riaposova Lucia
Author link: https://covid19-data.nist.gov/pid/rest/local/author/riaposova_lucia
Author Name: Mounier Jack Sandra
Author link: https://covid19-data.nist.gov/pid/rest/local/author/mounier_jack_sandra
Author Name: Kampmann Beate
Author link: https://covid19-data.nist.gov/pid/rest/local/author/kampmann_beate
Author Name: Holder Beth
Author link: https://covid19-data.nist.gov/pid/rest/local/author/holder_beth
sha: 7fd4839fcbe593ed0bd82c74e7020a937e916b8b
license: cc-by
license_url: https://creativecommons.org/licenses/by/4.0/
source_x: Medline; PMC; WHO
source_x_url: https://www.medline.com/https://www.ncbi.nlm.nih.gov/pubmed/https://www.who.int/
pubmed_id: 35030996
pubmed_id_url: https://www.ncbi.nlm.nih.gov/pubmed/35030996
pmcid: PMC8759061
pmcid_url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759061
url: https://doi.org/10.1186/s12884-021-04321-3 https://www.ncbi.nlm.nih.gov/pubmed/35030996/
has_full_text: TRUE
Keywords Extracted from Text Content: Women pregnant women COVID-19 vaccines August-11th women UK COVID-19 vaccine South-East regions B COVID-19 left Fig. 3A COVID-19 vaccines 41 SBe HS NHS advice JCVI COVID-19 vaccine Black-other C COVID-19 Fig. 4E S1457 Instagram coronavirus participants D COVID-19 patients South-East Covid trimester pregnant women COVID-19 Black-British SBa S1340 line Free-text Facebook non-pregnant COVID-19 [13 Covid 19 researchers/GP COVID-19 vaccine " Fig. 1 HS babies £ COVID-19: i) thing"(Interviewee 06 Women people Facebook's S1236 supplementary Table 1 Vaccine COVID-19 [27] Mumsnet Fig. 4D tick-box COVID-19 vaccines COVID-19 vaccine views [2] [3] [4] SARS-CoV-2 National Health Service NHS UK's Joint Black-British Caribbean women S1270 Facebook landing page S1317 regressions-one ECMO COVID-19 vaccines' £45,000-64,999 E COVID-19 UK women children Vaccines Supplementary Table 1 SBe cell Covid -19 vaccines [1] UK Fig. 4C A. SBa tick-box SMJ HS LR, HS participants SBe
Extracted Text Content in Record: First 5000 Characters:Background: COVID-19 vaccines are advised for pregnant women in the United Kingdom (UK) however COVID-19 vaccine uptake among pregnant women is inadequate. Methods: An online survey and semi-structured interviews were used to investigate pregnant women's views on COVID-19 vaccine acceptability for themselves when pregnant, not pregnant and for their babies. One thousand one hundred eighty-one women, aged over 16 years, who had been pregnant since 23rd March 2020, were surveyed between 3rd August-11th October 2020. Ten women were interviewed. The majority of women surveyed (81.2%) reported that they would 'definitely' or were 'leaning towards' accepting a COVID-19 vaccine when not pregnant. COVID-19 vaccine acceptance was significantly lower during pregnancy (62.1%, p < 0.005) and for their babies (69.9%, p < 0.005). Ethnic minority women were twice as likely to reject a COVID-19 vaccine for themselves when not pregnant, pregnant and for their babies compared to women from White ethnic groups (p < 0.005). Women from lower-income households, aged under 25-years, and from some geographic regions were more likely to reject a COVID-19 vaccine when not pregnant, pregnant and for their babies. Multivariate analysis revealed that income and ethnicity were the main drivers of the observed age and regional differences. Women unvaccinated against pertussis in pregnancy were over four times more likely to reject COVID-19 vaccines when not pregnant, pregnant and for their babies. Thematic analysis of the survey freetext responses and interviews found safety concerns about COVID-19 vaccines were common though wider mistrust in vaccines was also expressed. Trust in vaccines and the health system were also reasons women gave for accepting COVID-19 vaccines. Given this guidance, understanding pregnant women's' perspectives on the acceptability of being vaccinated against COVID-19 is vital. We present here the first multi-methods study exploring UK women's views on the acceptability of COVID-19 vaccination in pregnancy, as well as their views on vaccination for their babies, and for themselves when not pregnant. At the start of the SARS-CoV-2 pandemic in 2020, there was a lack of evidence on the risk of COVID-19 disease in pregnant women [2] . It is now known that while pregnant women do not appear to be at greater risk of contracting SARS-CoV-2 there is a small risk of severe illness with COVID-19 disease, particularly in the last trimester of pregnancy (i.e. from 28 to 40 weeks of pregnancy) [2] [3] [4] . Since the beginning of the pandemic in the United Kingdom (UK), as a precaution pregnant women have been classed as 'vulnerable' to COVID-19 and advised to carefully adhere to social distancing guidance by the National Health Service (NHS), particularly in the third trimester of pregnancy [5, 6] . Despite calls by experts [7] , pregnant women were not included in the initial COVID-19 vaccine trials, though COVID-19 vaccine trials involving pregnant women have now started [8] . In the UK, the general COVID-19 vaccination programme began in December 2020 with prioritisation of those at greater risk of hospitalisation or being severely ill with COVID-19 and those caring for vulnerable individuals, such as health and social care workers [9] . Initial guidance from the UK's Joint Committee on Vaccination and Immunisation (JCVI), was that pregnant women should not be offered COVID-19 vaccination due to a lack of data on the safety of COVID-19 vaccines during pregnancy [9] . In contrast, in the United States of America (USA) the Centers for Disease Control and Prevention (CDC) advised that pregnant women could be offered COVID-19 vaccination with information available to enable pregnant women to make informed decisions [10] . The UK guidance was changed on December 30th 2020 [11] , with pregnant women at greater risk of contracting COVID-19 (e.g. frontline healthcare workers) or at greater risk of severe disease due to other risk factors being able to be vaccinated following a discussion with a healthcare professional [11] . Given the availability of a larger databases on vaccine safety following the introduction of the vaccines, primarily from the USA [12] , this recommendation was then amended to include all pregnant women in line with the rest of the population, with mRNA vaccines identified as the preferred product to be offered [1] . Ethnic minorities are at higher risk of dying from COVID-19 [13] , and in the UK pregnant women from Black or other ethnic minority groups are overrepresented among women admitted to hospital with COVID-19 infection during pregnancy [4] . Work by Bell et al. found that parents from ethnic minority backgrounds other than White in the UK are less likely to accept a COVID-19 vaccine for their children [14] . This finding is consistent with other reports that individuals from ethnic minorities are less likely to accept COVID-19 vaccination for themselves [15, 16] . For example, the Office for Natio
Keywords Extracted from PMC Text: £45,000-64,999 Fig. 4E UK's Joint Committee Fig. 1 S1340 trimester SBa Facebook 'm effects."(survey Fig. 4D –Fig [1] researchers/GP Covid -19 vaccines COVID-19 [13 Facebook's Fig. 4C tick-box Instagram JCVI COVID-19 vaccine views COVID-19 vaccine Vaccines Covid 19 S1317 £ participants COVID-19 SBe HS UK women NHS COVID-19: i) patients COVID-19 vaccine ' people S1236 women's pregnant women children COVID-19 vaccines women Black-British Free-text Mumsnet HS cell's South-East regions UK women's Supplementary Table 1 Covid I'd NHS advice' South-East Facebook landing page babies Fig. 4A regressions-one Women Black-British Caribbean Black-other S1457 SBe utero' 's National Health Service " line 've UK's Fig. 3A COVID-19 vaccines' coronavirus COVID-19 vaccine " SARS-CoV-2 UK
Extracted PMC Text Content in Record: First 5000 Characters:On the 16th April 2021, the United Kingdom's (UK) Joint Committee on Vaccination and Immunisation (JCVI) announced that pregnant women should be offered the COVID-19 vaccine 'at the same time as the rest of the population, based on their age and clinical risk group'. [1] Given this guidance, understanding pregnant women's' perspectives on the acceptability of being vaccinated against COVID-19 is vital. We present here the first multi-methods study exploring UK women's views on the acceptability of COVID-19 vaccination in pregnancy, as well as their views on vaccination for their babies, and for themselves when not pregnant. At the start of the SARS-CoV-2 pandemic in 2020, there was a lack of evidence on the risk of COVID-19 disease in pregnant women [2]. It is now known that while pregnant women do not appear to be at greater risk of contracting SARS-CoV-2 there is a small risk of severe illness with COVID-19 disease, particularly in the last trimester of pregnancy (i.e. from 28 to 40 weeks of pregnancy) [2–4]. Since the beginning of the pandemic in the United Kingdom (UK), as a precaution pregnant women have been classed as 'vulnerable' to COVID-19 and advised to carefully adhere to social distancing guidance by the National Health Service (NHS), particularly in the third trimester of pregnancy [5, 6]. Despite calls by experts [7], pregnant women were not included in the initial COVID-19 vaccine trials, though COVID-19 vaccine trials involving pregnant women have now started [8]. In the UK, the general COVID-19 vaccination programme began in December 2020 with prioritisation of those at greater risk of hospitalisation or being severely ill with COVID-19 and those caring for vulnerable individuals, such as health and social care workers [9]. Initial guidance from the UK's Joint Committee on Vaccination and Immunisation (JCVI), was that pregnant women should not be offered COVID-19 vaccination due to a lack of data on the safety of COVID-19 vaccines during pregnancy [9]. In contrast, in the United States of America (USA) the Centers for Disease Control and Prevention (CDC) advised that pregnant women could be offered COVID-19 vaccination with information available to enable pregnant women to make informed decisions [10]. The UK guidance was changed on December 30th 2020 [11], with pregnant women at greater risk of contracting COVID-19 (e.g. frontline healthcare workers) or at greater risk of severe disease due to other risk factors being able to be vaccinated following a discussion with a healthcare professional [11]. Given the availability of a larger databases on vaccine safety following the introduction of the vaccines, primarily from the USA [12], this recommendation was then amended to include all pregnant women in line with the rest of the population, with mRNA vaccines identified as the preferred product to be offered [1]. Ethnic minorities are at higher risk of dying from COVID-19 [13], and in the UK pregnant women from Black or other ethnic minority groups are overrepresented among women admitted to hospital with COVID-19 infection during pregnancy [4]. Work by Bell et al. found that parents from ethnic minority backgrounds other than White in the UK are less likely to accept a COVID-19 vaccine for their children [14]. This finding is consistent with other reports that individuals from ethnic minorities are less likely to accept COVID-19 vaccination for themselves [15, 16]. For example, the Office for National statistics in the UK found that 21% of Black or Black British adults have either declined or are unlikely to accept COVID-19 vaccination compared to only 4% of White adults [17]. We have previously shown that acceptance of pertussis and influenza vaccines in pregnancy is also lower in this group [18, 19]. Parental decisions about childhood vaccinations have also been shown to begin in pregnancy [20], so it is therefore useful to assess pregnant women's perspectives on COVID-19 vaccines for both themselves and their children. Understanding women's views and acceptability of COVID-19 vaccination is also important to address given that over 98% of pregnant women admitted to hospital with COVID-19 between 1st February 2021 to 30th September 2021 were unvaccinated [21]. We conducted a multi-methods study to investigate the views of pregnant women in the UK on the likely uptake of a future COVID-19 vaccine for themselves and their children. At the time of the survey no COVID-19 vaccines had been licensed for use but there was a recognition that COVID-19 vaccination could be made routinely available to pregnant women, children, and women of childbearing age in the future. Eligible participants were required to have been pregnant at some point between the start of the UK 2020 lockdown (from 23rd March 2020) and the time of survey completion, to be resident in the UK, and to be aged 16 years or over. The survey was live from 3rd August – 11th October 2020. The online survey was prefaced by an informati
PDF JSON Files: document_parses/pdf_json/7fd4839fcbe593ed0bd82c74e7020a937e916b8b.json
PMC JSON Files: document_parses/pmc_json/PMC8759061.xml.json
G_ID: womens_views_on_accepting_covid_19_vaccination_during_and_after_pregnancy_and_for