Psychosocial Predictors of COVID-19 Vaccine Uptake among Pregnant Women: A Cross-Sectional Study in Greece

Abstract

An understanding of the factors associated with the COVID-19 vaccine uptake in pregnant women is paramount to persuade women to get vaccinated against COVID-19. We estimated the vaccination rate of pregnant women against COVID-19 and evaluated psychosocial factors associated with vaccine uptake among them. We conducted a cross-sectional study with a convenience sample. In particular, we investigated socio-demographic data of pregnant women (e.g., age, marital status, and educational level), COVID-19 related variables (e.g., previous COVID-19 diagnosis and worry about the side effects of COVID-19 vaccines), and stress due to COVID-19 (e.g., danger and contamination fears, fears about economic consequences, xenophobia, compulsive checking and reassurance seeking, and traumatic stress symptoms about COVID-19) as possible predictors of COVID-19 vaccine uptake. Among pregnant women, 58.6% had received a COVID-19 vaccine. The most important reasons that pregnant women were not vaccinated were doubts about the safety and effectiveness of the COVID-19 vaccines (31.4%), fear that COVID-19 vaccines could be harmful to the fetus (29.4%), and fear of adverse side effects of COVID-19 vaccines (29.4%). Increased danger and contamination fears, increased fears about economic consequences, and higher levels of trust in COVID-19 vaccines were related with vaccine uptake. On the other hand, increased compulsive checking and reassurance seeking and increased worry about the adverse side effects of COVID-19 vaccines reduced the likelihood of pregnant women being vaccinated. An understanding of the psychosocial factors associated with increased COVID-19 vaccine uptake in pregnant women could be helpful for policy makers and healthcare professionals in their efforts to persuade women to get vaccinated against COVID-19. There is a need for targeted educational campaigns to increase knowledge about COVID-19 vaccines and reduce vaccine hesitancy in pregnancy.

COVID-19 Vaccination Acceptance During Pregnancy in Europe

“…Acceptance rates vary across European countries (Table 1 ). In Italy, up to 82.7% expressed an intention to get vaccinated [ 24 - 27 ], while active vaccination acceptance ranged from 21.3% to 79.9% [ 25 , 26 , 28 , 29 ]. Acceptance rates in Greece ranged from 53.9% [ 30 ] to 58.6% [ 31 ], while in Turkey it reached 37.7% [ 32 ].…”

“…In Greece, primary reasons for non-vaccination during pregnancy included concerns about the safety and effectiveness of COVID-19 vaccines, fear of potential harm to the fetus, and apprehensions about long-term side effects. Conversely, positive drivers for COVID-19 vaccine acceptance in pregnancy encompassed fears of COVID-19 severity, concerns about financial impact [ 29 ], a high acceptance of pediatric vaccines, vaccination against influenza during the current or previous pregnancy, and vaccination against pertussis during the current pregnancy [ 30 ]. Sociodemographic data indicated a significant and positive correlation between vaccine acceptability and employment, higher maternal age, and greater monthly income [ 30 ].…”

“…Our review indicates that data related to prior COVID-19 infection and acceptance were inconsistent in pregnant women [ 25 , 27 , 29 , 38 ].…”

“…Having an underlying condition or a high-risk pregnancy was related to a higher acceptance rate [ 26 , 35 , 29 ]. According to Khan et al [ 46 ], pregnant women with comorbidities had a 3.72-fold higher chance (95% CI: 1.57-8.83) to accept COVID-19 vaccine compared with pregnant women without comorbidities.…”