“But what if…” : The Influence of COVID-19 on Vaccination Acceptance during Pregnancy in the US Southeast Restricted; Files & ToC

Perry, Tahira (Spring 2023)

Permanent URL: https://etd.library.emory.edu/concern/etds/0p096820s?locale=en


Introduction: Vaccination serves as an efficient primary means of control for infectious disease. However, in the case of the COVID-19 pandemic, literature suggests that pregnant women within the United States had the lowest rates of COVID-19 vaccination and intent to vaccinate during the initial onset of the global pandemic. The purpose of this study is to describe the social implications of COVID-19 and pregnancy on vaccine decision-making, contextualize this decision-making process for pregnant people during the pandemic and analyze the factors that informed COVID-19 vaccination uptake during pregnancy. 


Methods: This study uses data from a mixed-methods study that examined the impact of COVID-19 on women’s experiences of pre-natal care, birth support and delivery in the US South. The research team utilized Dedoose and created a dual inductive-deductive code book analysis of in-depth interviews (n=20) with women (18+ years old) who discovered their pregnancy by January 2020, and had their prenatal care and delivery during the pandemic beginning in March 2020. The transcriptions were de-identified and thematically analyzed to highlight prominent themes across participants associated with their birthing experience, COVID vaccination status and considerations. Participants completed a brief demographic online survey that included questions about their pregnancy history and COVID-19 vaccination status and a separate psychosocial survey, the results of which were used to analyze participant data based on vaccination status. 


Results: Participants cite three major themes when discussing their considerations of COVID-19 vaccine decision-making during pregnancy. The themes included decisional conflict leading to COVID-19 vaccine hesitancy, the intersection between support and resources sharing as a tool for empowerment, and vaccination as an opportunity to regain connection. Additionally, participants reported the impact of prior adverse reproductive experiences on COVID-19 vaccine hesitancy during pregnancy.  


Conclusions: This study begins to address the gap in knowledge about what factors that are important for pregnant women when vaccine decision making and how different contexts and personal identifies shape how those factors are weighed. The findings from our study provide insight into the lived experiences of pregnant women during the COVID-19 pandemic, the struggles to find substantial data for vaccine safety among birthing populations, how social and clinical support influences perinatal decisions, and the impact of prior adverse reproductive experiences on individual calculus. Notably, understanding this relationship will allow for enhancement of vaccine dissemination strategy and advocacy for vaccine trial inclusion for the population.  

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