Background COVID-19 vaccines are recommended for pregnant and lactating individuals, and there is substantial evidence for their safety and effectiveness. As the pandemic continues, information on worries and beliefs surrounding perinatal COVID-19 vaccination remains important to inform efforts aimed at improving vaccine uptake. Our objectives were to assess factors associated with COVID-19 vaccination among perinatal individuals; and to explore motivational factors associated with willingness to be vaccinated among unvaccinated perinatal individuals. Methods This was a cross-sectional web-based survey of preconception, pregnant, and lactating individuals in Canada. The outcomes of interest were vaccination with at least one dose of any COVID-19 vaccine and willingness to be vaccinated among unvaccinated individuals. Sample characteristics were summarized using frequencies and percentages. The association between eight prespecified risk factors and two outcomes (vaccination status and willingness to be vaccinated) was assessed by logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for the total sample, and across perinatal sub-groups. Results Among 3446 survey respondents, there were 447 (13.0%) preconception, 1832 (53.2%) pregnant, and 1167 (42.4%) lactating. There were 1460 (42.4%) and 1982 (57.5%) who were vaccinated and unvaccinated, respectively. Factors positively associated with COVID-19 vaccine status were speaking to a healthcare provider about vaccination during the perinatal period (aOR:2.35, 95% CI:1.97–2.80) and believing that the COVID-19 vaccine is effective (aOR:1.91, 95% CI:1.46–2.48). Factors negatively associated with vaccine status included worries about fetal growth and development (aOR:0.55, 95% CI:0.43–0.70) and future child behavioral/neurodevelopmental problems (aOR:0.59, 95% CI:0.46–0.75). Among unvaccinated individuals specifically, characteristics positively associated with willingness to vaccinate were speaking to a healthcare provider (aOR:1.67, 95% CI:1.32–2.12) and believing the COVID-19 vaccine is effective (aOR:3.56, 95% CI:2.70–4.69). Factors negatively associated with willingness were concerns over infertility (aOR:0.66, 95% CI:0.49–0.88), fetal growth and development (aOR:0.33, 95% CI:0.24–0.46), and future child behavioral/neurodevelopmental problems (aOR:0.64, 95% CI:0.48–0.84). Conclusions In this Canadian perinatal population, approximately 42% reported COVID-19 vaccination. Among unvaccinated individuals, willingness to receive vaccination was high (73%). Factors enhancing vaccine willingness included discussions with healthcare providers and believing the vaccine was effective. Concerns regarding vaccine safety, particularly with respect to fetal/child development, were the greatest barriers to vaccine uptake.

Objectives: The aim of this study was to describe the psychological impact of the COVID-19 pandemic and the specific impact of a universal SARS-CoV-2 testing programme on obstetric patients and healthcare workers at The Ottawa Hospital. Methods: This was a follow-up survey study of obstetric healthcare workers and then-pregnant patients who participated in a SARS-CoV-2 testing programme conducted in The Ottawa Hospital obstetrical triage units from 19 October to 17 November 2020. Surveys explored the effects of the COVID-19 pandemic and the testing programme on participants’ psychological well-being. Responses were collected from April to September 2021. Descriptive summary statistics were calculated for both groups. Results: During hospitalization for delivery, obstetric patients (n = 143) worried about giving COVID-19 to their new baby (88.11%), catching COVID-19 (83.22%), and giving COVID-19 to their partner (76.22%). Patients felt relief at being tested for COVID-19 during the universal testing programme (24.65%) and at getting their results (28.87%). Patients also believed that universal SARS-CoV-2 testing was a good way to slow COVID-19 spread (79.72%), reduce anxiety (75.52%), and increase relief (76.22%). In addition, patients felt good about participating in research that could help others (91.61%). Among obstetric healthcare workers (n = 94), job satisfaction decreased and job stress increased during the COVID-19 pandemic. The universal testing programme led to minor increases in healthcare worker job stress and burden, particularly among nurses, but the majority (85.23%) believed it was a valuable research initiative. Conclusion: The COVID-19 pandemic has had a negative psychological impact on obstetric patients and healthcare workers. Universal SARS-CoV-2 testing was generally viewed favourably and may serve as an effective strategy for estimating COVID-19 prevalence without adding undue stress onto patients and healthcare workers during the pandemic.

T he onset of the COVID-19 pandemic saw the widespread implementation of policies in clinical care settings to protect vulnerable patient populations. 1 Among these populations are obstetric patients, who are at increased risk for severe complications related to COVID-19, including admission to hospital and to the intensive care unit. 2 Pregnant individuals require regular and frequent access to health care services and most are ultimately admitted to the hospital for delivery. 3 Temporary adoption of universal COVID-19 screening and testing approaches in some obstetric departments provided important insight for local hospital administrators and public health authorities on the prevalence of SARS-CoV-2 infection in obstetric patients. Early estimates of SARS-CoV-2 prevalence among pregnant individuals are highly variable, ranging from 0.012% to 37%. 4,5 Variability in these estimates reflects differences in population density across settings, socioeconomic composition, available technology for laboratory testing, timing and duration of testing programs, and local community infection rates. 6 Furthermore, cautious and appropriate interpretation of serologic assays are necessary when estimating seroprevalence, given the emerging evidence on serologic cross-reactivity and antibody decay, 7,8 particularly in populations with low levels of exposure. 9