Covid-19 vaccine acceptance lowest among pregnant women and mothers of young kids in US, says global survey
Pregnant women who were reluctant said they had concerns about exposing their baby to possible harmful side effects, the vaccine being rushed for political reasons and lack of safety and data
There is substantial geographic variation in the acceptance of the coronavirus vaccination among pregnant women and mothers of children younger than 18 years of age, according to researchers. They found that globally, vaccine acceptance was lowest in the US, Russia and Australia.
Vaccine acceptance was highest in India, the Philippines and all sampled countries in Latin America. Overall, 52% of pregnant women and 73% of non-pregnant women said they would receive such a vaccine, and 69% of all women surveyed said they would vaccinate their children.
The strongest predictors of Covid-19 vaccine acceptance were confidence in vaccine safety and efficacy, belief in the importance of vaccines/mass vaccination to their own country, confidence in routine childhood vaccines, worried about coronavirus, the trust of public health agencies/health science as well as compliance to mask guidelines.
“Our study confirmed that Covid-19 vaccine hesitancy is multifaceted. The perceived threat of Covid-19, level of trust in public health agencies, and existing pre-coronavirus vaccine attitudes play key roles in shaping vaccine acceptance and confidence. Vaccination campaigns should be tailored to alleviate these specific concerns,” suggests Julia Wu, senior author of the paper from the Harvard TH Chan School of Public Health.
Coronavirus vaccines are being distributed around the world, but until now researchers have had little data about global vaccine acceptance. To assess pregnant women and mothers’ stances on whether to vaccinate themselves and their children, the team conducted an online survey administered by the Pregistry website between late October and mid-November 2020.
“The Covid-19 vaccine trials generated very limited data on safety and efficacy for pregnant women and children. Since mothers are often key decision-makers for whether their children will receive vaccinations, it is important to measure vaccine confidence among mothers of young children and to investigate the predictors for their vaccine acceptance or reluctance, in order to prepare for Covid-19 vaccination efforts,” explains the study published in the European Journal of Epidemiology.
Almost 18,000 women in 16 countries responded to questions about a hypothetical safe and free Covid-19 vaccine with 90% efficacy. Results suggest that coronavirus vaccine acceptance and its predictors among pregnant women and mothers of young children vary globally.
Among pregnant women, 52% (2,747) intended to receive Covid-19 vaccination during their pregnancy if an efficacy of 90% was achieved. “Responses among pregnant women varied substantially by country (range: 28.8-84.4%). Covid-19 vaccine acceptance level was above 80% for pregnant women in Mexico and India; and below 45% for the US, Australia, and Russia,” reveals the analysis.
Among non-pregnant women, 73.4% (9,214 out of 12,562) intended to receive the vaccination. Covid-19 vaccine acceptance among non-pregnant women also varied substantially between countries (range: 48.6-93.1%). Vaccine acceptance level was above 90% for non-pregnant mothers in India, Brazil, and Mexico; and below 56% for Australia, the US, and Russia.
Among the 17,054 women who stated their likelihood to vaccinate their children, results were very similar. Vaccine acceptance levels among mothers for their children were above 85% in India, Mexico, Brazil, and Colombia; and below 52% for Australia, the US and Russia. This country-variable pattern persisted after standardizing for key demographics including age, education, income and marital status.
Overall, 53% of women were confident that a nationally approved coronavirus vaccine would be safe, with no harmful side effects, and 60.4% were confident that such a vaccine would be effective, protecting most people who receive the vaccine.
The perceived seriousness of coronavirus and the importance of prevention measures were also highly variable among the 16 sampled countries, and it did not correspond to the infection rate in the country. Women’s level of worry about Covid-19 in the US and Russia was comparable to that in lower incidence countries (Australia and New Zealand). Despite this variation in concern, self-reported compliance with local mask-wearing regulations was above 75% in all countries.
The majority of women in the 16 countries believed it was important for their own country to have a Covid-19 vaccine (85.8%), and for most people in their own country to get vaccinated (82.6%).
Top reasons for vaccine reluctance
The three most important reasons for pregnant women to refuse coronavirus vaccination during pregnancy even if the vaccine were safe and free were that they did not want to expose their developing baby to any possible harmful side effects (65.9%), were concerned that approval of the vaccine would be rushed for political reasons (44.9%) and would like to see more safety and effectiveness data among pregnant women (48.8%).
The top reasons for mothers to be unwilling to have their child/children vaccinated for Covid-19 were that they are concerned that approval of the vaccine will be rushed for political reasons (39.8%), would like to see more safety and effectiveness data among children (32.7%), and believe that the vaccine is not safe and could have harmful side effects (28.4%).
Healthcare providers had a limited impact: only 45.9% of pregnant women and 54.6% of non-pregnant women would be more likely to have themselves/children vaccinated if recommended by healthcare providers.
According to investigators, as global vaccine rollouts continue, monitoring acceptance and its predictors will provide policymakers with key insights to understand public willingness and make informed policies that are effective.
“It is especially urgent for countries currently experiencing widespread public distrust during the pandemic to rebuild vaccine confidence through transparent communication and effective community engagement. Covid-19 vaccine education campaigns need to emphasize the pandemic as a whole and what’s at stake for communities, instead of a limited focus of vaccine safety and effectiveness,” recommends the team.