Influences on Vaccine Decision-Making During Pregnancy

Pregnant people are at greater risk for vaccine-borne illness yet are more vaccine hesitant than the general population. Hesitancy toward COVID-19 vaccination emerged among pregnant individuals during the COVID-19 pandemic, with vaccine hesitancy also reported in previous vaccine acceptors. With the clear benefits of vaccination for pregnant individuals and their neonates, it is essential to investigate vaccine hesitancy. Therefore, the purpose of this study was to explore the perceptions and decision-making processes of pregnant individuals regarding COVID-19 vaccination during pregnancy.

A qualitative descriptive design with semistructured interviews was used for the study. A convenience sample of pregnant or recently pregnant individuals who spoke English or Spanish was obtained. Interviews were conducted until data saturation was achieved, and the interviews were translated (when necessary) and transcribed. Members of the research team analyzed interview transcripts separately, coded and organized the data into themes, and then collaborated to reach a consensus on the final themes.

There were 41 interviews conducted, with 10 participants self-identifying as Spanish, Hispanic, or Latino. Influences on decision-making included trust in health care providers, fear of complications from vaccination, fear of adverse effects from COVID-19 infection, perceived vaccine safety and efficacy, perceptions surrounding immunity, novelty of the COVID-19 vaccine, perceived positive health status, spiritual and religious influences, and influences from family members and friends. Information sources that participants described using in their vaccine decision-making included information obtained from family members who were health care professionals, the Centers for Disease Control and Prevention, and internet and social media sources that participants perceived as valid.

The findings reveal the impact of health care providers' recommendations on the COVID-19 vaccine decision-making process for pregnant individuals, highlighting the crucial role health care providers play in disseminating accurate vaccine information. Safety concerns regarding the vaccine and vaccination to prevent illness were described, showing that health care providers should address these concerns when providing vaccine information.