Download PDF
CC BY 4.0 · Rev Bras Ginecol Obstet 2023; 45(11): e638-e645
DOI: 10.1055/s-0043-1772589
Original Article
Obstetrics

Factors Related to Low COVID-19 Vaccination Rate in Pregnant and Postpartum Women with and without COVID-19

Fatores relacionados à baixa taxa de vacinação contra COVID-19 em gestantes e puérperas com e sem COVID-19
Dilek Menekse Beser 
1   Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
,
Derya Uyan Hendem 
1   Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
,
Deniz Oluklu 
1   Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
,
Ezgi Turgut 
1   Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
,
Necati Hancerliogullari 
2   Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
,
Sule Goncu Ayhan 
1   Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
,
Ozlem Moraloglu Tekin 
2   Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
,
Dilek Sahin 
3   Division of Perinatology, Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Objective This study focused on pregnant and postpartum women during the COVID-19 pandemic, aiming to determine the attitudes and behaviors of vaccinated and unvaccinated groups, and the vaccination behaviors in the groups with and without the disease. The reasons for refusing the vaccine were also questioned.

Methods This cross-sectional study was performed from September 2021 to October 2021. The study data were collected using a face-to-face questionnaire. The participants were pregnant women who applied to the hospital for routine antenatal care and were hospitalized, and women in the postpartum period. Additionally, pregnant and postpartum patients who were diagnosed with COVID-19 at the time of admission and were hospitalized and admitted to the intensive care unit due to this disease were also included in the study.

Results A total of 1,146 pregnant and postpartum women who completed the questionnaire were included in our study. Only 43 (3.8%) of the participants were vaccinated; 154 (13.4%) of the participants had comorbidities. The number of COVID-19-positive patients was 153. The lack of sufficient information about the safety of the COVID-19 vaccine is the most common reason for the refusal.

Conclusion Vaccine refusal can significantly delay or hinder herd immunity, resulting in higher morbidity and mortality. Considering the adverse effects of COVID-19 on pregnancy, it is essential to understand pregnant and postpartum women's perceptions toward vaccination to end the pandemic.

Keywords

COVID-19 vaccine - postpartum women - pregnancy - vaccine acceptance - vaccine hesitancy

Contributors

All authors were involved in the design and interpretation of the analyses, contributed to the writing of the manuscript, and read and approved the final manuscript.




Publication History

Received: 09 February 2023

Accepted: 27 April 2023

Article published online:
29 November 2023

© 2023. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Liu X, Liu C, Liu G, Luo W, Xia N. COVID-19: Progress in diagnostics, therapy and vaccination. Theranostics 2020; 10 (17) 7821-7835
    CrossrefPubMedGoogle Scholar
  • 2 Wang CL, Liu YY, Wu CH, Wang CY, Wang CH, Long CY. Impact of COVID-19 on Pregnancy. Int J Med Sci 2021; 18 (03) 763-767
    CrossrefPubMedGoogle Scholar
  • 3 Liu H, Wang LL, Zhao SJ, Kwak-Kim J, Mor G, Liao AH. Why are pregnant women susceptible to COVID-19? An immunological viewpoint. J Reprod Immunol 2020; 139: 103122
    CrossrefPubMedGoogle Scholar
  • 4 Villar J, Ariff S, Gunier RB. et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr 2021; 175 (08) 817-826
    CrossrefPubMedGoogle Scholar
  • 5 Sahin D, Tanacan A, Erol SA. et al. Management of pregnant women with COVID-19: A tertiary pandemic center experience on 1416 cases. J Med Virol 2022; 94 (03) 1074-1084
    CrossrefPubMedGoogle Scholar
  • 6 Ndwandwe D, Wiysonge CS. COVID-19 vaccines. Curr Opin Immunol 2021; 71: 111-116
    CrossrefPubMedGoogle Scholar
  • 7 Chen F, Zhu S, Dai Z. et al. Effects of COVID-19 and mRNA vaccines on human fertility. Hum Reprod 2021; 37 (01) 5-13
    CrossrefPubMedGoogle Scholar
  • 8 Fu W, Sivajohan B, McClymont E. et al. Systematic review of the safety, immunogenicity, and effectiveness of COVID-19 vaccines in pregnant and lactating individuals and their infants. Int J Gynaecol Obstet 2022; 156 (03) 406-417
    CrossrefPubMedGoogle Scholar
  • 9 Boelig RC, Aagaard KM, Debbink MP, Shamshirsaz AA. Research Committee, Society for Maternal-Fetal Medicine (SMFM), SMFM Research Committee. Electronic address: smfm@smfm.org. Society for Maternal-Fetal Medicine Special Statement: COVID-19 research in pregnancy: progress and potential. Am J Obstet Gynecol 2021; 225 (06) B19-B31
    CrossrefPubMedGoogle Scholar
  • 10 Covid C. Vaccination. Centers for Disease Control and Prevention. Available online: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/no-cost.html (accessed on 17 December 2021)
    PubMedGoogle Scholar
  • 11 World Health Organization. Ten health issues WHO will tackle this year. https://www.who.int/news-room/spotlight/ten-threatsto-global-health-in-2019 . Accessed 22 Dec 2020
    PubMedGoogle Scholar
  • 12 SAGE Working Group on Vaccine Hesitancy. Report of the SAGE Working Group on Vaccine Hesitancy. https://www.who.int/immunization/sage/meetings/2014/october/SAGE_working_group_revised_report_vaccine_hesitancy.pdf . Accessed 22 Dec 2020
    PubMedGoogle Scholar
  • 13 Neumann-Böhme S, Varghese NE, Sabat I. et al. Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19. Eur J Health Econ 2020; 21 (07) 977-982
    CrossrefPubMedGoogle Scholar
  • 14 Burgess RA, Osborne RH, Yongabi KA. et al. The COVID-19 vaccines rush: participatory community engagement matters more than ever. Lancet 2021; 397 (10268): 8-10
    CrossrefPubMedGoogle Scholar
  • 15 Lin C, Tu P, Beitsch LM. Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review. Vaccines (Basel) 2020; 9 (01) 16
    CrossrefPubMedGoogle Scholar
  • 16 Goncu Ayhan S, Oluklu D, Atalay A. et al. COVID-19 vaccine acceptance in pregnant women. Int J Gynaecol Obstet 2021; 154 (02) 291-296
    CrossrefPubMedGoogle Scholar
  • 17 Oluklu D, Goncu Ayhan S, Menekse Beser D. et al. Factors affecting the acceptability of COVID-19 vaccine in the postpartum period. Hum Vaccin Immunother 2021; 17 (11) 4043-4047
    CrossrefPubMedGoogle Scholar
  • 18 DeBolt CA, Bianco A, Limaye MA. et al. Pregnant women with severe or critical coronavirus disease 2019 have increased composite morbidity compared with nonpregnant matched controls. Am J Obstet Gynecol 2021; 224 (05) 510.e1-510.e12
    CrossrefPubMedGoogle Scholar
  • 19 Skjefte M, Ngirbabul M, Akeju O. et al. COVID-19 vaccine acceptance among pregnant women and mothers of young children: results of a survey in 16 countries. Eur J Epidemiol 2021; 36 (02) 197-211
    CrossrefPubMedGoogle Scholar
  • 20 Golob JL, Lugogo N, Lauring AS, Lok AS. SARS-CoV-2 vaccines: a triumph of science and collaboration. JCI Insight 2021; 6 (09) e149187
    CrossrefPubMedGoogle Scholar
  • 21 Dagan N, Barda N, Kepten E. et al. BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting. N Engl J Med 2021; 384 (15) 1412-1423
    CrossrefPubMedGoogle Scholar
  • 22 Wendt A, Santos TM, Cata-Preta BO. et al. Children of more empowered women are less likely to be left without vaccination in low- and middle-income countries: A global analysis of 50 DHS surveys. J Glob Health 2022; 12: 04022
    CrossrefPubMedGoogle Scholar
  • 23 Flor LS, Friedman J, Spencer CN. et al. Quantifying the effects of the COVID-19 pandemic on gender equality on health, social, and economic indicators: a comprehensive review of data from March, 2020, to September, 2021. Lancet 2022; 399 (10344): 2381-2397
    CrossrefPubMedGoogle Scholar
  • 24 Razai MS, Chaudhry UAR, Doerholt K, Bauld L, Majeed A. Covid-19 vaccination hesitancy. BMJ 2021; 373 (1138) n1138
    CrossrefPubMedGoogle Scholar
  • 25 Kothari A, Pfuhl G, Schieferdecker D. et al. The barrier to vaccination is not vaccine hesitancy: patterns of COVID-19 vaccine acceptance over the course of the pandemic in 23 countries. medRxiv. 2021:2021.2004.2023.21253857
    PubMedGoogle Scholar
  • 26 Marzo RR, Sami W, Alam MZ. et al. Hesitancy in COVID-19 vaccine uptake and its associated factors among the general adult population: a cross-sectional study in six Southeast Asian countries. Trop Med Health 2022; 50 (01) 4
    CrossrefPubMedGoogle Scholar
  • 27 Hwang T-J, Rabheru K, Peisah C, Reichman W, Ikeda M. Loneliness and social isolation during the COVID-19 pandemic. Int Psychogeriatr 2020; 32 (10) 1217-1220
    CrossrefPubMedGoogle Scholar
  • 28 Sinaci S, Ozden Tokalioglu E, Ocal D. et al. Does having a high-risk pregnancy influence anxiety level during the COVID-19 pandemic?. Eur J Obstet Gynecol Reprod Biol 2020; 255: 190-196
    CrossrefPubMedGoogle Scholar
  • 29 Mortazavi F, Mehrabadi M, KiaeeTabar R. Pregnant women's well-being and worry during the COVID-19 pandemic: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21 (01) 59
    CrossrefPubMedGoogle Scholar
  • 30 Pfizer B. Pfizer and BioNTech announce vaccine candidate against COVID-19 achieved success in first interim analysis from phase 3 study. Pfizer New York; 2020
    Google Scholar
  • 31 Pratama NR, Wafa IA, Budi DS, Putra M, Wardhana MP, Wungu CDK. mRNA Covid-19 vaccines in pregnancy: A systematic review. PLoS One 2022; 17 (02) e0261350
    CrossrefPubMedGoogle Scholar
  • 32 Dağdeviren G, Örgül G, Yücel A, Şahin D. Tetanus vaccine during pregnancy: data of a tertiary hospital in Turkey. Turk J Med Sci 2020; 50 (08) 1903-1908
    CrossrefPubMedGoogle Scholar