Using the Health Belief Model to Identify Predictors of COVID-19 Vaccine Acceptance among a Sample of Pregnant Women in the U.S.: A Cross-Sectional Survey

Abstract

The aim of the study was to identify factors that predict acceptance of the COVID-19 vaccine among pregnant women. Using the Health Belief Model, the authors administered a cross-sectional survey of pregnant and postpartum women in the United States during the COVID-19 pandemic. Overall, 227 women agreed to participate and completed the entire survey. Over half (59%) the participants had received the COVID-19 vaccine at the time of the study. Perceived barriers to vaccination (p < 0.001) and perceived benefits (p < 0.001) to vaccination were statistically significant predictors of vaccination. Trust in healthcare providers was also statistically predictive of vaccination (p = 0.001). Binary regression results were statistically significant (χ2(9) = 79.90, p < 0.001), suggesting that perceived benefits, barriers, severity, and susceptibility scores had a statistically significant effect on the odds of a participant being vaccinated. Results indicate a need for increased patient education regarding COVID-19 vaccination during pregnancy, including the benefits of vaccination for mother and fetus.

Within-Country Inequality in COVID-19 Vaccination Coverage: A Scoping Review of Academic Literature

“…In contrast, the opposite pattern—higher vaccination among younger groups—was reported in 8 articles (6%). These articles focused on adult populations across different settings, including health care workers in China [ 29 ] and Egypt [ 30 ]; university students or staff in the United States [ 31 , 32 ]; active military personnel in Israel [ 33 ]; pregnant or postpartum women in the United States [ 34 ]; and general adult populations in Singapore [ 35 ] and the United States [ 36 ].…”

A Systematic Review of Population-Based Studies Assessing Knowledge, Attitudes, Acceptance, and Hesitancy of Pregnant and Breastfeeding Women towards the COVID-19 Vaccine

“…At the end of the screening process, a total of 64 articles were considered included. However, due to the high heterogeneity in terms of outcomes assessed and its definition as well as study setting, we decided to present in the current manuscript only population-based studies (a total of 21 included studies) [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. Consultation with experts did not add any further eligible studies.…”

“…COVID-19 vaccine acceptance was investigated in nine studies [ 23 , 24 , 25 , 26 , 29 , 30 , 31 , 32 , 39 ], with acceptance rates ranging from approximately 20% [ 39 ] to 68% [ 26 ] ( Table 4 ). The most frequently reported reasons for accepting the COVID-19 vaccine were to protect mother and baby, the perceived beneficial effect, and satisfactory research on safety [ 26 ].…”

“…Moreover, several factors were found to be associated with COVID-19 vaccine acceptance. In particular, being older than 30 years [ 24 , 26 ], ethnicity (Asian [ 26 ], black/Africans ethnicity [ 29 ], and in general minorities [ 24 ]), higher income [ 26 , 29 ], higher education [ 24 ], having received the influenza vaccine [ 32 ], or all recommended vaccines [ 24 ], having received healthcare provider recommendation [ 30 , 32 ], were all statistically significant associated with higher acceptance. Moreover, higher knowledge on COVID-19 vaccine was associated with higher acceptance rate [ 30 ]; on the contrary, fear of side effects both for women and newborns and perceived barriers for vaccination [ 24 ] were associated with lower acceptance rate [ 30 ].…”

“…In particular, being older than 30 years [ 24 , 26 ], ethnicity (Asian [ 26 ], black/Africans ethnicity [ 29 ], and in general minorities [ 24 ]), higher income [ 26 , 29 ], higher education [ 24 ], having received the influenza vaccine [ 32 ], or all recommended vaccines [ 24 ], having received healthcare provider recommendation [ 30 , 32 ], were all statistically significant associated with higher acceptance. Moreover, higher knowledge on COVID-19 vaccine was associated with higher acceptance rate [ 30 ]; on the contrary, fear of side effects both for women and newborns and perceived barriers for vaccination [ 24 ] were associated with lower acceptance rate [ 30 ]. Lastly, the perceived threat of COVID-19 [ 29 ], perceived benefits of the COVID-19 vaccine [ 24 ], behavioral attitudes toward infection mitigation, and living with a higher-risk subjects [ 32 ] were also statistically significant associated with higher acceptance.…”