Zhang Ran, Byrd Tiffany, Qiao Shan, Torres Myriam E, Li Xiaoming, Liu Jihong
Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America.
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America.
medRxiv. 2023 Jul 24:2023.07.20.23292951. doi: 10.1101/2023.07.20.23292951.
COVID-19 vaccination is vital for ending the pandemic but concerns about its safety among pregnant and postpartum women, especially among African American (AA) and Hispanic women, persist. This study aims to explore factors that influence vaccination decision-making among AA and Hispanic pregnant and postpartum women through women's experiences and maternal care providers' (MCPs) observations.
From January and August 2022, we conducted semi-structured interviews with AA and Hispanic women and MCPs. Participants were recruited from obstetric and pediatric clinics in South Carolina, and all births took place after March 2020. Thematic analysis was employed for data analysis.
The study involved 19 AA and 20 Hispanic women, along with 9 MCPs, and revealed both barriers and facilitators to COVID-19 vaccination. The factors that influence pregnant and postpartum women's decision about COVID-19 vaccine uptake included: 1) awareness of health threats associated with COVID-19 vaccines, 2) vaccine availability and accessibility, 3) vaccine-related knowledge and exposure to misinformation, 4) concerns regarding pre-existing health conditions and potential side effects of COVID-19 vaccines, 5) emotional factors associated with vaccination decision-making processes, 6) concerns about the well-being of infants, 7) cultural perspectives, and 8) encouragement by trusted supporters.
Findings suggest that reliable information, social support, and trusted doctors' advice can motivate COVID-19 vaccination. However, barriers such as misinformation, mistrust in the health care system, and fears related to potential side effects impede vaccination uptake among AA and Hispanic pregnant and postpartum women. Future interventions should target these barriers, along with health disparities, involve trusted doctors in outreach, and initiate vaccine conversations to promote vaccination among this population.
新冠病毒疫苗接种对于终结疫情至关重要，但孕妇和产后女性，尤其是非裔美国人和西班牙裔女性对其安全性的担忧依然存在。本研究旨在通过女性的经历以及孕产妇护理提供者（MCP）的观察，探索影响非裔美国人和西班牙裔孕妇及产后女性疫苗接种决策的因素。
2022年1月至8月，我们对非裔美国人和西班牙裔女性以及MCP进行了半结构化访谈。参与者从南卡罗来纳州的产科和儿科诊所招募，所有分娩均发生在2020年3月之后。采用主题分析法进行数据分析。
该研究纳入了19名非裔美国女性和20名西班牙裔女性，以及9名MCP，揭示了新冠病毒疫苗接种的障碍和促进因素。影响孕妇和产后女性接种新冠病毒疫苗决策的因素包括：1）对与新冠病毒疫苗相关的健康威胁的认识；2）疫苗的可获得性和可及性；3）与疫苗相关的知识以及接触到的错误信息；4）对既有健康状况和新冠病毒疫苗潜在副作用的担忧；5）与疫苗接种决策过程相关的情感因素；6）对婴儿健康的担忧；7）文化观念；8）值得信赖的支持者的鼓励。
研究结果表明，可靠的信息、社会支持和值得信赖的医生建议可以促使人们接种新冠病毒疫苗。然而，诸如错误信息、对医疗保健系统的不信任以及对潜在副作用的恐惧等障碍，阻碍了非裔美国人和西班牙裔孕妇及产后女性接种疫苗。未来的干预措施应针对这些障碍以及健康差距，让值得信赖的医生参与宣传，并开展关于疫苗的对话，以促进这一人群的疫苗接种。
