Acceptance and Rejection of Covid-19 Vaccine among Pregnant and Breast Feeding Women – a survey conducted in Outpatient Department of a tertiary care setup

Abstract

Aim: To ascertain the frequency of acceptance and rejection of covid-19 vaccination and the reasons behind their choices among pregnant and breast feeding women visiting outpatient department of a tertiary care setup. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Unit -1 for a period of one month. All women attending outpatient department during the study, fulfilling the inclusion criteria and willing to participate in the study were included after informed consent. A questionnaire designed to acquire general information about the study participant was filled by the researcher. Data was entered and analyzed using SPSS vr 21.0. Results: Out of 500 enrolled women, 249(49.8%) women were pregnant and 251(51.2%) were breast feeding. 171(34.2%) were vaccinated and 329(65.8%) were unvaccinated. There is a significant association between the concept regarding unavailability of significant data regarding safety during pregnancy and breast feeding or vaccine being harmful during pregnancy and breast-feeding for mother & baby and acceptance of vaccine (p-value < 0.001) Conclusion: Safety concerns regarding the vaccine for pregnant and breast-feeding mothers still hold them from getting vaccinated. Obstetricians and Gynaecologists of the country need to play a vital role in building up the confidence of this population over vaccination and should strongly recommend pregnant and breast feeding women following up in clinics to get vaccinated. Keywords: Covid vaccination, pregnancy, breast-feeding and covid vaccine, Covid pandemic.

COVID-19 Vaccine Knowledge, Attitude, Acceptance and Hesitancy among Pregnancy and Breastfeeding: Systematic Review of Hospital-Based Studies

“…All the studies were performed in gynecological or maternal units at public or private hospitals. Recruitment was performed by inviting consecutive women attending the clinic in approximately half of the cases (n = 25/43) [2,20,[24][25][26]29,30,33,35,[37][38][39][40]42,44,46,47,49,[51][52][53][54]56,60,61], random sampling was employed in four studies (n = 4), antenatal care registry was used in three studies (n = 3) [21,36,59], convenience sampling was adopted in other three studies (n = 3) [27,28,32], multistage sampling approach was used in two studies (n = 2) [55,58], the snow-ball method was used in one study (n = 1) [22], and one study used data from an ongoing prospective longitudinal cohort study (n = 1) [50]. Four studies did not specify the recruitment method adopted [23,31,45,48].…”

“…Seven studies used on-line administration [24,[27][28][29]33,54,60], five studies performed a self-administration (paperbased) [22,32,37,49,51] and two studies used a telephone administration [36,50]. Eight studies did not report information regarding administration methods [20,23,25,31,52,53,55,59].…”

“…The vast majority of included studies (n = 30/43) exclusively recruited pregnant women, while four studies focused solely on postpartum/breastfeeding women [25,41,48,50]. The remaining studies included both pregnant and postpartum/breastfeeding women [20,22,24,39,40,51,52,57,61]. Women's ages were reported as mean and standard deviation, or mean and interquartile range, or range, or percentage; however, the youngest women were 18 years old, while the oldest were 49 years old.…”

“…Not Significant Significant Not Significant Data Availability unavailability of data regarding safety during pregnancy and breast-feeding [20]; no need to receive information on COVID-19 vaccine 0.41 (0.21-0.79) [41]; feel the vaccine was rushed OR: 0,16 (0.10-0.27) [52]; believe people of their race were included in trials OR: 2.65 (1.79-3.92) [52] Education lower level of education (aOR: 2.49, (1.13-5.51) [55]; higher education OR: 0.81 (0.62-0.95) [27]; higher educational level 1.92 (1.03-3.57) [41]; higher educational level aOR: 4.2 (2.1-8.5) [34]; higher educational level aOR 3.48 (1.52-7.95) [43]; higher educational level 2.8 (1.51-4.21) [42]; higher educational level 5.99 (1.12-32.16) [51]; level of education significantly differed between groups [56] Educational status [20,21,36,45,54] Higher educational level aOR: 0.05 (0.02-0.13) [2]; lower educational level OR: 0.38 (0.15-0.92) [41]; lower education level OR: 3.42 (1.24-9.45) [22]; lower educational level aOR: 4.93 (2.47-9.83) [25] Educational level [30,31,38,46,50] Efficacy Confidence in vaccine efficacy OR = 1.85 (0.38, 9.11) [49]; believe vaccine will protect them against COVID-19 OR: 0 10.75 (6.73-17.17) [52]; believe vaccine will protect their baby from COVID-19 OR: 6.36 (4.16-9.73) [52] Believe that vaccine during pregnancy increase the newborn's immunity aOR: 0.28 (0.08-0.98) [25] Believe that vaccine is ineffective [41] Ethnicity Afro-Caribbean 0.27 (0.06-0.85) [23]; Asian ethnicity significantly more frequently reported among vaccinated women [29]; Bedouin aOR 0.20 (0.18-0.23) [59] ...…”

Determinants of Non-Acceptance of the COVID-19 Vaccine During Pregnancy in Pregnant and Postpartum Women: A Descriptive Cross-Sectional Study

“…On 31st December 2019, the first outbreak of SARSCoV-2 (coronavirus disease 2019 [COVID-19]) spread rapidly throughout Wuhan, China, and involved more than 213 countries in the world. The World Health Organization (WHO) declared COVID-19 as an International Emergency Concern on January 30, 2020 ( 1 ). pregnant and postpartum women Compared with nonpregnant women affected by COVID-19 may be more prone to severe disease course and complications including requiring hospitalization, intensive care unit (ICU) admission, ventilator usage, requiring intubation, and/or death ( 2 , 3 ).…”