Perceptions of the COVID-19 vaccines among people from racial and ethnic minority groups in the United States who were pregnant during the COVID-19 pandemic: Four virtual focus groups, June 2021

Full Description:

Background: COVID-19 vaccination protects people from severe illness and death from COVID-19. Data from the Vaccine Safety Datalink indicate that only 35% of people aged 18-49 years received ≥1dose of COVID-19 vaccine prior to or during pregnancy, with the lowest uptake (20%) among pregnant people who are black, non-Hispanic (as of October 30, 2021). This is concerning because people from racial and ethnic minority groups have been disproportionately burdened by COVID-19, and pregnant people are at increased risk for severe illness from COVID-19.

Methods: To better understand perceptions and uptake of COVID-19 vaccination among pregnant people from racial and ethnic minority groups, CDC funded March of Dimes to conduct focus groups with this population. Eligible participants were pregnant, at least 18 years old, from a racial or ethnic minority group, and living in the US. Groups were segmented by those who received ≥1 dose of a COVID-19 vaccine (two groups of 8) and those who had not received any dose but were considering vaccination (two groups of 8). Focus groups were held virtually in June 2021.

Results: A total of 32 people participated, ranging in age from 21 to 41 years. Fourteen participants were Black, five were Asian, one was Native American, and 12 were Hispanic. Twenty-six participants were from an urban setting, and five had underlying medical conditions. Both vaccinated and non-vaccinated participants reported accurate knowledge about the effects of COVID-19 during pregnancy and expressed concerns about the impact of COVID-19 on their baby, reporting use of multiple methods for prevention of COVID-19, including mask-wearing and staying home.

In the vaccinated groups, most participants said they had a conversation with their healthcare provider about the COVID-19 vaccine, but provider engagement was less reliably reported among the non-vaccinated. Vaccinated groups reported that testimonials from pregnant people who were vaccinated positively influenced their decision. Among non-vaccinated groups, reasons for not getting vaccinated included distrust of healthcare and government, lack of research about the long-term impacts of the vaccine on infants, and a belief that they were sufficiently protected using their current prevention methods.

Conclusion/Implications: Insights from these discussions suggest a variety of communication strategies that were effective for vaccinated groups, including talking with a healthcare provider, could be useful for communicating with unvaccinated people from these study populations. Although these focus groups occurred before CDC had a strong recommendation for COVID-19 vaccination during pregnancy, messaging to this population should include robust information about the safety and effectiveness of the vaccines. Other strategies might include messaging from trusted influencers, highlighting potential benefits to infants, and sharing testimonials from people who decided to get vaccinated.

Abbreviated Description: Focus groups were conducted with 32 pregnant participants from racial and ethnic minority groups to understand perceptions of COVID-19 vaccination. Both vaccinated and non-vaccinated participants reported accurate knowledge about the effects of COVID-19 during pregnancy. Reasons for delaying vaccination included distrust of healthcare and government, the speed of vaccine development, lack of research about long-term impacts of the vaccine, and a belief that they were sufficiently protected using current prevention methods. Insights from these discussions suggest that talking with a healthcare provider and sharing testimonials from people who decided to get vaccinated might help pregnant people from racial/ethnic minority groups make an informed decision about COVID-19 vaccination.