PM2080: COVID-19 Perinatal Transmission and Vaccine Decisions in Hispanic Parents

Background: A significant portion of Hispanic parents (33-50%) report COVID-19 vaccine hesitancy for their children and Hispanic American pregnant women are less likely to receive the vaccine compared to Asian or White women. The assumption that Hispanic Americans are inherently more likely to display vaccine hesitancy is rooted in a legacy of bias and racism. Rather, unjust historical practices such as forced sterilization and current immigration concerns have resulted in a mistrust of medical organizations. To properly address this disparity, healthcare professionals must approach this community with an empathetic understanding of their perspectives regarding the COVID-19 vaccine to strengthen relationships through established trust.

This is especially critical in light of emerging research that suggests that intrapartum COVID-19 infections stimulate adverse fetal immune responses and are associated with preterm delivery, while vaccination during third trimester neutralizes this risk and confers additional short-term infant immunoprotection. Additionally, many questions remain about perinatal transmission and long-term effects of the COVID-19 virus in children.

Methods: We conducted 15 qualitative parent interviews in the clinic setting to investigate themes in vaccine motivations and/or hesitancy in regards to their children.

We will also complete a chart review of newborn records with intrauterine or perinatal exposure or maternal vaccination to the COVID-19 virus. We will study the long-term passive immune response to COVID-19 in this cohort over 5 years. Serial quantitative COVID-19 antibody levels and inflammatory T Cell response analysis will be used to measure the extent of immunoprotection.

Results: Interview transcripts suggest that families are generally accepting of COVID-19 vaccination. However, misconceptions about side effects and mistrust of governmental health agencies drive hesitancy. Interestingly, unrelated maternal personal medical trauma resulted in preference to defer the vaccine for themselves and for their children. 53% of parents declined the vaccine for their child. However, of this group, 50% stated they were unsure and would likely vaccinate their children in the future.

Preliminary labor and delivery records indicate that 15% of the newborns had perinatal exposure to the COVID-19 virus while 15% had a positive COVID-19 test after one month of age (n=26). Vaccine deferral rate among pregnant mothers was 32%.

Conclusion: Adverse effect misconceptions, mistrust, and separate personal medical trauma are major barriers to vaccination. Additionally, preliminary chart review analysis has identified a group of infants with exposure to the COVID-19 virus. Future steps include tracking changing vaccine perspectives among hesitant families and comparing immune responses between exposed and non-exposed infants.