College of Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA.
BJOG. 2022 Jul;129(8):1352-1360. doi: 10.1111/1471-0528.17189. Epub 2022 May 19.
To examine the association between initial COVID-19 vaccine hesitancy and subsequent vaccination among pregnant and postpartum individuals.
Prospective cohort.
A Midwestern tertiary-care academic medical center. Individuals completed a baseline vaccine hesitancy assessment from 22 March 2021 to 2 April 2021, with subsequent ascertainment of vaccination status at 3-6 months follow-up.
We used multivariable Poisson regression to estimate the relative risk of vaccination by baseline vaccine hesitancy status, and then characteristics associated with vaccination.
Self-report of COVID-19 vaccination, and secondarily, consideration of COVID-19 vaccination among those not vaccinated.
Of 456 individuals (93% pregnant, 7% postpartum) initially surveyed, 290 individuals (64%; 23% pregnant, 77% postpartum) provided subsequent vaccination status (median = 17 weeks). Of these 290 individuals, 40% (116/290) reported COVID-19 vaccine hesitancy upon enrolment, of whom 52% reported subsequent vaccination at follow-up. Few individuals transitioned during the study period from vaccine hesitant to vaccinated (10%); in comparison, 80% of those who were not vaccine hesitant were vaccinated at follow-up (aRR 0.19, 95% CI 0.11-0.33). Among those who remained unvaccinated at follow-up, 38% who were vaccine hesitant at baseline were considering vaccination, compared with 71% who were not vaccine hesitant (aRR 0.48, 95% CI 0.33-0.67). Individuals who were older, parous, employed and of higher educational attainment were more likely to be vaccinated, and those who identified as non-Hispanic black, were Medicaid beneficiaries, and were still pregnant at follow-up were less likely to be vaccinated.
COVID-19 vaccine hesitancy persisted over time in the peripartum period, and few individuals who reported hesitancy at baseline were later vaccinated. Interventions that address vaccine hesitancy in pregnancy are needed.
探讨初始 COVID-19 疫苗犹豫与妊娠和产后个体后续接种之间的关系。
前瞻性队列研究。
中西部三级保健学术医疗中心。个人于 2021 年 3 月 22 日至 2021 年 4 月 2 日完成疫苗犹豫评估基线，随后在 3-6 个月随访中确定疫苗接种状况。
我们使用多变量泊松回归来估计疫苗接种的相对风险，然后确定与疫苗接种相关的特征。
自我报告的 COVID-19 疫苗接种情况，其次是未接种疫苗者对 COVID-19 疫苗接种的考虑。
在最初接受调查的 456 名个体（93%为孕妇，7%为产后）中，290 名个体（64%；23%为孕妇，77%为产后）提供了后续疫苗接种状况（中位数=17 周）。在这 290 名个体中，40%（116/290）在入组时报告 COVID-19 疫苗犹豫，其中 52%在随访时报告了后续接种。在研究期间，很少有个体从疫苗犹豫者转变为接种者（10%）；相比之下，80%的非疫苗犹豫者在随访时接种了疫苗（ARR0.19，95%CI0.11-0.33）。在随访时仍未接种疫苗的个体中，38%的基线时疫苗犹豫者正在考虑接种疫苗，而 71%的非疫苗犹豫者（ARR0.48，95%CI0.33-0.67）。年龄较大、多产、就业和受教育程度较高的个体更有可能接种疫苗，而那些自我认同为非西班牙裔黑人、是医疗补助计划的受益人、随访时仍怀孕的个体则不太可能接种疫苗。
在围产期期间，COVID-19 疫苗犹豫持续存在，很少有报告基线犹豫的个体随后接种疫苗。需要针对妊娠期间的疫苗犹豫进行干预。
