ABSTRACT
INTRODUCTION: Immunization against SARS-COV-2 protects pregnant persons from severe COVID-19 illness. Pregnant individuals are less likely (19.2%) to be vaccinated against COVID-19 than their non-gravidas counterparts (69.6%). This disparity may be attributed to a lack of knowledge regarding the risks of SARS-COV-2 infection in pregnancy and the benefits and safety of vaccination. This study aims to determine the impact of patients' self-reported COVID-19 knowledge on COVID-19 vaccination rates during pregnancy. METHODS: A total of 359 postpartum patients consented to participate in an institutional review board-approved cross-sectional survey at an urban academic medical center in Miami, Florida between July and September 2021. Participants self-reported their COVID-19 vaccination status and answered questions to assess their general knowledge regarding COVID-19 infection and its impact on pregnancy, as well as knowledge of current guidelines for vaccination in pregnancy and safety of vaccination in pregnancy and breastfeeding. Correct responses to each item earned 1 point, while incorrect responses detracted 1 point, yielding knowledge scores ranging from -5 to +5. RESULTS: The mean knowledge score across participants was 1.7±1.77. Controlling for age and education, a 1-point increase in knowledge score was associated with a 1.6-times increase in the odds of vaccination. There was a monotonic increase in vaccination rates as knowledge score rose (P<.001). CONCLUSION: The strongly positive correlation between knowledge scores and vaccination emphasizes the vital role that knowledge plays in the decision to be vaccinated for gravida individuals. This elucidates the importance of empowering pregnant persons with reputable and accurate information to increase the likelihood of vaccination in this at-risk population.
ABSTRACT
INTRODUCTION: Immunization plays an essential role in protecting the mother and child dyad from serious illnesses. Despite current recommendations from the American College of Obstetricians and Gynecologist, Advisory Committee on Immunization Practices, and Centers for Disease Control and Prevention, vaccination rates in the U.S. are significantly below 100%. The aim of this study is to assess uptake of influenza, Tdap, and COVID-19 vaccination in pregnancy among a culturally diverse population in South Florida. METHODS: An institutional review board-approved cross-sectional survey was administered among inpatient postpartum persons between July and September 2021. The 359 enrolled participants completed a survey assessing basic demographics and vaccination history. Chisquare tests, set at a significance level of P<.05, compared uptake of each vaccine by ethnicity and U.S.-born status. RESULTS: Of the 359 participants, 67.7% self-identified as White, 67.4% reported Hispanic ethnicity, and 68.5% were non-U.S.-born. Compared to the 2019-2020 national average, Tdap vaccine uptake in this cohort was higher (74.7% versus 56.6%) and influenza vaccine uptake was lower (45.1% versus 61.2%). COVID-19 vaccine uptake during the study period mirrored the national average (18.1% versus 18.9%). Generally, there was higher vaccination uptake among Hispanics and non-U.S.-born individuals. However, a significant difference was only observed for uptake in influenza vaccine between U.S.-born and non-U.S.-born persons (chisquare=11.54, P=.0007). CONCLUSION: The suboptimal rates of influenza, Tdap, and COVID-19 vaccination seen in this cohort demonstrate the necessity for interventions to improve education about the safety and effectiveness of vaccination in pregnancy. Furthermore, increased efforts to maximize availability and access to vaccines during prenatal care are also needed. Together, these strategies may increase vaccine uptake in pregnancy, especially across diverse populations.