(791) Decision-Making Regarding COVID-19 Vaccine Administration Among Birthing People in the Peripartum Period

To identify factors contributing to patient decision-making toward COVID-19 vaccination in pregnancy.

Study Design:

Prospective qualitative study of English-speaking birthing people hospitalized for treatment of COVID-19 during pregnancy at a single quaternary care center from August 2021 to March 2022. Semi-structured interviews were conducted after hospitalization to examine factors surrounding COVID-19 vaccine uptake prior to or after diagnosis of COVID-19 in pregnancy. All interviews were audio-recorded, professionally transcribed and iteratively coded for inductive narrative analysis.

Results:

Eight birthing people were identified for qualitative analysis (Table 1). Barriers included perceived potential of maternal-fetal harm and media messaging around COVID-19 vaccine complications, distrust of the healthcare system and obstetrical racism, and lack of understanding of how vaccines work. Birthing people who chose to be vaccinated were motivated by a desire to protect themselves and their children, a higher risk for infection due to chronic health conditions and receiving counseling from a healthcare provider they viewed as trustworthy and willing to have open conversations regarding concerns about COVID-19 vaccination in pregnancy. Additional factors facilitating vaccination included employer mandates, support among family members, and familiarity with vaccine technology (Table 2).

Conclusion:

Decisions regarding COVID-19 vaccine uptake in pregnancy are multifactorial for birthing people. Taking action to get vaccinated was undermined by the uncertainty of risks associated with the vaccine and lack of meaningful communication with healthcare providers, whereas vaccine uptake was facilitated by clear information in trusting relationships. Further study is warranted to determine optimal methods for providing patient education and advocating for uptake of the COVID vaccine among birthing people.