Vaccine uptake in the obstetric population - too little too late?

ABSTRACT

Introduction: Since April 2021, UK guidance recommends pregnant women should be vaccinated against SARS-CoV-2. Vaccine uptake in this population is low, though reasons for this remain poorly understood [1,2]. We aimed to characterise uptake of SARS-CoV-2 vaccines in patients admitted to two inner-city maternity units (∼8500 deliveries per year). Methods: Caldicott Guardian approval was obtained and formal ethical review was waived. All obstetric patients admitted to Princess Royal Maternity, Glasgow, and Royal Alexandra Hospital, Paisley, between 1 May 2021 and 23 January 2022 and who tested positive for SARS-CoV-2 were included. Results: There were 98 women (median [IQR] age 29.5 [26–34] years, white ethnicity 74/98 [76%], most deprived socioeconomic quintile 56/ 98 [57%]). 19/98 women (19%) had received any SARS-CoV-2 vaccine prior to infection with 9/19 receiving their first vaccine pre-pregnancy and 10/19 during pregnancy at median (IQR) 22.3 (13.8–25.0) weeks gestation. 11/98 women (11%) had received two vaccines before infection. Oxygenwas required in 32/79 (41%) of unvaccinatedwomen and 3/19 (16%) women who had received any vaccine prior to infection. No double-vaccinated women required oxygen or critical care admission. 24 women (25%) received a first vaccine after delivery and 56 women (57%) remain unvaccinated. Discussion: Vaccine uptake was poor in this inner-city cohort, with only 19% and 11% having received any or two vaccines respectively prior to SARS-CoV-2 infection. Of those who had received any vaccine before infection, just over half received this during pregnancy. In a Scottish population study, 42.8% of all women giving birth in October 2021 had received any dose and 32.3% of women had received two doses [1]. The lower rates in our cohort may reflect our population being skewed towards more deprived groups. Our data supports the need for two vaccines for effective protection against severe COVID-19. Barriers to vaccination require urgent attention. (Figure Presented)