Safety concerns key to COVID-19 vaccination hesitancy in pregnancy

Pregnant women were hesitant to get the COVID-19 vaccine as a result of mixed public messaging and concerns over safety, according to the results of a study which analyzed social media posts.

The study, led by the University of York, focused on the posts of more than 1,000 pregnant women worldwide who had a due date between December 2020 and July 2022 and who refused the COVID-19 vaccine.

The study showed there was a general feeling of confusion about whether pregnant women should have the vaccine or not, likely made worse by changing guidance for the vaccine during the early days of the pandemic.

Dr. Su Golder, from the Department of Health Sciences at the University of York who led the study, said, "The most common reasons identified are safety concerns largely linked to the perceived speed at which the vaccine was created and the lack of data about its safety in pregnancy. This led to a preference to wait until after the baby is born or to take other precautions instead, including staying at home or wearing a mask when out in public."

"The next most common reason was complacency as a result of a belief that they are young and healthy or already had COVID-19 and do not need the vaccine. Misinformation led to false safety and efficacy allegations, or even conspiracy theories."

Several people in the study also felt anger at being categorized as 'anti-vax' if they refused the vaccine while pregnant when there were other contributing factors at play. Many women were not against vaccination but were rather cautious about getting vaccinated while pregnant.

Dr. Golder said, "Although guidance is now more clear about the benefits of getting the vaccine whilst pregnant than it was in the early days of the pandemic, we found that even through the latter stages of 2021 and early 2022, there was still hesitation which demonstrates the lasting impact that mixed public messages can have at crucial times in a crisis."

Evidence shows that pregnant women are at increased risk of severe illness with COVID-19 infection and COVID-19 is associated with preeclampsia, preterm birth, stillbirth and cesarean delivery.

A large body of evidence now suggests that COVID-19 vaccination is effective and safe during pregnancy, with international organizations and governments recommending vaccination. However, this was not the case at the beginning of the vaccine rollout as pregnant women were initially excluded from clinical trials.

The team of researchers, which also included the University of Pennsylvania and Cedars-Sinai Medical Center, hope that highlighting these hesitations, will help shape future public health campaigns and improve communication between healthcare professionals and patients.

The study is published in the BJOG: An International Journal of Obstetrics & Gynaecology.