Low COVID-19 vaccination rates among pregnant women could be increased if there was better communication from trusted midwives and GPs, according to new research.
St George’s and Frimley NSH Trust surveyed 441 pregnant women at two Surrey hospitals after it was estimated that less than one third of pregnant women have received the vaccine compared with more than three quarters of women who are not pregnant.
Concerns about the low uptake include the fact that pregnant women are more likely to experience severe COVID-19 disease, are admitted to intensive care three times as often and have a 25% greater chance of dying as their non-pregnant counterparts.
COVID-19 during pregnancy also results in a higher risk of pre-eclampsia, preterm birth, stillbirth and early neonatal death.
The survey, published in the latest edition of PLOS ONE, found that 66.2% of the respondents had received at least one dose of vaccine.
The most common reasons for not having the vaccine included concerns over possible adverse effects of the vaccine on the unborn baby, future pregnancies or the mother; lack of information about the vaccines’ safety and effectiveness; and lack of trust in COVID-19 vaccines.
The respondents said their most trusted sources of information were their GP and midwife (43%) and official health-related websites such as NHS (39%). However, 23% said they had used social media for information, which put them at risk of being exposed to misinformation and conspiracy theories.
After analysing the responses, the researchers made several recommendations that could improve vaccine uptake, including ensuring that trusted practitioners such as GPs, midwives and obstetricians are trained to engage pregnant women in empathetic, transparent conversations about vaccination during routine care.
They said respecting pregnant women’s concerns and addressing their information needs were important, especially when speaking to pregnant women from ethnic minority groups, who have higher vaccine hesitancy.
The researchers also suggest specific staff should be trained to act as vaccine champions, providing comprehensive and accurate information to pregnant women.
Study lead Dr Fatima Husain, a consultant obstetrician and gynaecologist, said: “The recommendations based on this study could improve both COVID-19 vaccine uptake and other routine immunisations, such as pertussis and influenza vaccines, during pregnancy. As a result of this survey, we have appointed vaccine champions at our hospital to inform women who may feel hesitant about vaccination.”
Co-author Dr Mohammad Razai of the Population Health Research Institute, added: “We hope that by sharing what we’ve learned, other healthcare professionals will consider how they can make sure that pregnant women receive information about vaccination from the most appropriate people.”
The researchers say the respondents may not be representative of the wider population of pregnant women and it 26% from ethnic minorities, fewer than previous studies of COVID-19 vaccine uptake in pregnant women, which could be why there was a higher reporting of vaccination uptake.
Another study, published in the latest edition of The BMJ, has found vaccination against COVID-19 during pregnancy is not associated with a higher risk of preterm birth, small for gestational age at birth, or stillbirth.
The Canadian study used a population-based birth registry to identify all liveborn and stillborn infants with a gestational age of at least 20 weeks or birth weight of at least 500g in Ontario, Canada between 1 May and 31 December 2021.
This information was then linked to the database that captures all COVID-19 immunisations in the province.
Of 85,162 births, 43,099 occurred in individuals who received one dose or more of a COVID-19 vaccine during pregnancy.
Vaccination during pregnancy was not associated with any increased risk of overall preterm birth (6.5% among vaccinated v 6.9% among unvaccinated), spontaneous preterm birth (3.7% v 4.4%), or very preterm birth (0.59% v 0.89%)
No increase was found in risk of small for gestational age at birth (9.1% v 9.2%) or stillbirth (0.25% v 0.44%).
COVID-19 vaccination uptake in 441 socially and ethnically diverse pregnant women PONE-D-22-11364R1 PLOS One 17 August 2022
Fell DB, Dimanlig-Cruz S, Regan AK et al. Risk of preterm birth, small for gestational age at birth, and stillbirth after COVID-19 vaccination during pregnancy: population based retrospective cohort study. BMJ 18 August 2022. doi: 10.1136/ bmj-2022-071416
Leave a Reply