Objective
Evaluation of vaccination status is standard of care in pregnancy in the United States. As such, the role of vaccine hesitancy and its potential risk to pregnant patients requires understanding, particularly in light of the COVID-19 global pandemic. We sought to evaluate COVID vaccination in pregnant patients and to describe congruence between Tdap, influenza, and COVID vaccination status in this gravid population.
Study Design
This retrospective cohort study included pregnant patients delivering at a single center over a three-month time period in 2021. Patients without vaccine data were excluded. Subjects were grouped based on COVID vaccine acceptance. Data on Tdap and influenza vaccine acceptance was also collected. Primary outcome was acceptance of either or both influenza and Tdap vaccines. Groups were compared using student’s t-test, chi-squared and logistic regression adjusted for age, nulliparity and insurance type.
Results
Of the 816 patients included in the analysis, 372 (46%) received at least one dose of COVID vaccine. Pregnant patients who received the COVID vaccine were more likely to be older, nulliparous, and privately insured (p< 0.001) (Table 1). Rates of Tdap (93% vs. 70%, p< 0.001) and influenza (79% vs. 39%, p< 0.001) vaccine administration were higher among those who received the COVID vaccine compared to those who did not. Acceptance of Tdap and influenza vaccine remained independently associated with receiving the COVID vaccine after controlling for confounders, with adjusted odds ratio (aOR) 4.83 (95% CI 2.99-7.78) for Tdap, aOR 5.51 (95% CI 3.95-7.70) for influenza, and aOR 5.66 (95% CI 4.07-7.86) for both.
Conclusion
These findings suggest a general hesitancy toward vaccination in pregnancy. This does not appear to be unique to COVID vaccination alone. Receipt of standard vaccines in pregnancy was more likely in those who chose to undergo COVID vaccination.
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