Pandemic Pregnancy Experiences and Risk Mitigation Behaviors: COVID-19 Vaccination Uptake in Canada

Pregnant people in Canada during the pandemic faced complex decision-making related to COVID-19 exposure risks and the safety of mitigation measures, including vaccines. To help inform future infectious disease-health promotion, we assessed pandemic pregnancy experiences and COVID-19 risk mitigation strategies.

Respondents, pregnant at any time after January 2020 in Canada, completed an online, cross-sectional, descriptive survey from September 2021 to February 2022. Logistic regression was used to identify predictive factors associated with COVID-19 vaccine uptake and history of infection.

A purposive sample of predominantly non-racialized, high socioeconomic status women (n = 564), 58.2% primigravid during the pandemic, reported high COVID-19 vaccine uptake (87.4%). Educational attainment beyond high school predicted COVID-19 vaccination (college AOR: 2.72, CI: 1.24-5.94, p < 0.001; university AOR 4.01, CI: 1.91-8.40, p < 0.001; post-graduate university AOR: 7.31, CI: 2.84-18.81, p < 0.001). Immigrant status reduced the likelihood of COVID-19 vaccination (AOR: 0.20; CI: 0.09-0.49, p < 0.001). Racialized participants were 2.78-fold more likely to report infection (CI:1.19-6.50, p = 0.018).

COVID-19 vaccination uptake was very high; however, vaccine hesitancy was evident among immigrants, with racialized participants more likely to report a history of COVID-19 infection. Tailored public health messaging using a health equity lens may yield more robust vaccine uptake for future infectious respiratory disease outbreaks.