(031) Characterizing Stress and Sources of Information Related to Vaccination Against SARS-CoV-2 During Pregnancy

Abstract: Background

Between December and March 2022, the Centers for Disease Control and Prevention reported that only 8.2% of women received one or both doses of the COVID-19 vaccine during pregnancy.1 Despite widespread evidence of this vaccine’s safety profile during pregnancy, concerns due pregnancy safety and limited self-knowledge can prevent vaccine uptake.2 To address this issue, our study characterizes sources of stress and anxiety as well as helpful resources that may influence COVID-19 vaccine uptake among pregnant individuals.



Method
Pregnant and postpartum patients received care at the Cleveland Clinic Foundation (CCF) Obstetrics and Gynecology Department offices and were recruited to participate in an anonymous survey. Participants were asked to self-report mental health history, vaccination status, and perceptions about stressors and decision-making related to COVID-19 and its vaccine. Results were analyzed using SAS 9.4, with hypothesis testing by Fisher’s exact test.


Results

Among the 140 who completed the survey, 128 were pregnant and 12 were postpartum. 74.3% of respondents self-identified as White, and 55.7% received the COVID-19 vaccine, while 44.3% did not receive the vaccine. A significantly higher percentage of respondents who did not receive the vaccine said they were more worried, stressed, or anxious about the COVID-19 vaccine because they were pregnant or breastfeeding, compared to those who were vaccinated (61.3% vs 26.9%, P< 0.001).



While speaking to any healthcare provider or a provider that was not an OB/GYN about the COVID-19 vaccine was not significantly associated with vaccination (P=0.054, and P=1.000, respectively), speaking to an OB/GYN specifically was significantly associated with vaccination (P=0.001).



Discussion

While the current literature reports speaking to a healthcare provider as a predictor of vaccination uptake against COVID-19 among pregnant populations,3 our results specifically suggest an association between vaccination and speaking to an OB/GYN. Considering that not receiving the vaccine was associated with higher levels of decision-related anxiety and lower rates of speaking with an OB/GYN, we suggest OB/GYNs are uniquely positioned to both promote vaccination and mediate stress and anxiety related to decision-making about the vaccine.



Conclusion

Among survey respondents receiving prenatal care at CCF, vaccine uptake was associated with counseling by an OB/GYN, suggesting that patient-education from these providers can play an important role in increasing vaccination rates and alleviating stressors associated with vaccination amongst pregnant and postpartum populations.

Bibliography



1. Centers for Disease Control and Prevention. CDC COVID Data Tracker. Centers for Disease Control and Prevention (2022).

2. Battarbee, A. N. et al. Attitudes Toward COVID-19 Illness and COVID-19 Vaccination among Pregnant Women: A Cross-Sectional Multicenter Study during August–December 2020. American Journal of Perinatology 39, 075–083 (2022).

3. Huddleston, H. G. et al. COVID-19 vaccination patterns and attitudes among American pregnant individuals. Am J Obstet Gynecol MFM 4, 100507 (2022).