Oral Presentation
Vaccines
Emeline Maisonneuve, MD (she/her/hers)
PhD student
Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
Bern, Bern, Switzerland
Eva Gerbier
PhD student
Pharmacy department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Lausanne, Vaud, Switzerland
Fatima Tauqeer
PhD student
Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, , Oslo, Norway
Oslo, Oslo, Norway
Léo Pomar, PhD
Midwife and Professor
Materno-fetal and Obstetrics Research Unit, Woman-Mother-Child Department, CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Lausanne, Switzerland
Guillaume Favre, MD
PhD student
Materno-fetal and Obstetrics Research Unit, Woman-Mother-Child Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Lausanne, Vaud, Switzerland
Ursula Winterfeld, PhD
Pharmacist
Pharmacy department, CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Lausanne, Vaud, Switzerland
Anneke Passier, PhD
Teratology information specialist
Teratology Information Service, Pharmacovigilance Centre Lareb, ‘s Hertogenbosch, The Netherlands
Lareb, Netherlands
Alison Oliver, PhD
Senior Medical Information Scientist
UKTIS, Newcastle upon Tyne Hospitals, NHS Foundation Trust and the UK Health Security Agency, Newcastle upon Tynes, UK
Newcastle upon Tyne, United Kingdom
David Baud, MD PhD
Head of department
Materno-fetal and Obstetrics Research Unit, Woman-Mother-Child department, CHUV Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Lausanne, Switzerland
Hedvig Nordeng, PhD
Professor
Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
Oslo, Oslo, Norway
Michael Ceulemans, PhD
Pharmacist and researcher
Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
Leuven, Belgium
Alice Panchaud, PhD
Head of BIHAM Pharmacy
Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
Bern, Bern, Switzerland
Background: The vaccination against coronavirus disease 2019 (COVID-19) is of particular importance to pregnant and lactating women. Despite the growing evidence of the benefits and safety of vaccination in pregnant women, vaccination hesitancy among pregnant and breastfeeding women was 48.4%, according to a meta-analysis pooling 46 studies published until February 2022. It is critical to know which women should be specifically targeted with vaccination campaigns or during counselling in healthcare practice. Our study aim was to assess COVID-19 vaccine status and vaccination willingness in five European countries and search for determinants associated with the vaccination or willingness to get vaccinated against COVID-19 among pregnant and postpartum women during the 3rdwave of the pandemic.
Methods: This study was a cross-sectional, web-based survey conducted in Belgium, Norway, Switzerland, the Netherlands, and United Kingdom (UK), between June 10th and August 22nd, 2021. The primary outcome was defined using a composite variable “vaccinated or willing to get vaccinated” including women already vaccinated and unvaccinated women who reported there were willing to get vaccinated during pregnancy or breastfeeding.
Results: In total, 5210 women participated in the survey. After exclusion of 216 pregnant and 140 postpartum women who did not answer the question on COVID-19 vaccination status and of one unvaccinated participant who did not answer to the question about vaccine willingness, there were 3194 pregnant women and 1659 postpartum women included in the analysis on the COVID-19 vaccination. The proportions of pregnant women already vaccinated or willing to get vaccinated were 80.5%, 78.5%, 62.6%, 32.1% and 21.5% in Belgium, the UK, the Netherlands, Switzerland, and Norway, respectively. Among them, the characteristics associated with COVID-19 vaccination or willingness were living in Belgium, UK, Netherlands and Switzerland, compared to Norway, chronic illness (adjusted odds ratio (aOR) and 95% confidence interval (95%CI)=1.49; 1.13-1.97), history of flu vaccine (aOR=1.50; 1.11-2.04), belief that COVID is more severe during pregnancy (aOR=1.67; 1.21-2.32), belief that the COVID vaccine is effective (aOR=2.68; 1.30-5.86) and belief that the COVID vaccine is safe during pregnancy (aOR=39.2; 23.6-68.4). COVID vaccination adherence was negatively associated with third trimester of pregnancy (aOR=0.31; 0.20-0.46).
The proportions of postpartum women already vaccinated or willing to get vaccinated were 86.0%, 85.7%, 81.0%, 62.6% and 58.6% in the UK, Belgium, Norway, the Netherlands, and Switzerland, respectively. Among them, the determinants associated with COVID-19 vaccination or willingness were living in Belgium, and Netherlands, compared to Norway, chronic illness (aOR=2.19; 1.22-4.15), history of flu vaccine (aOR=3.27; 1.95-5.52), and belief that the COVID vaccine is safe during breastfeeding (aOR=79.1; 39.6-171.9). COVID vaccination adherence was negatively associated with breastfeeding (aOR=0.33; 0.11-0.91).
Conclusion: Vaccine hesitancy depends on socio-demographic factors, but especially on the opinion that the vaccine is safe. Knowledge of this major decision-making element is essential to better understand and overcome vaccine hesitancy. Multifactorial strategies, in particular based on the dissemination of the results of studies on the absence of excess risk when vaccinating during pregnancy and breastfeeding, seem to be necessary to overcome low vaccine coverage.