Intention to Receive COVID-19 Vaccine during Pregnancy: A Systematic Review and Meta-analysis

Alireza A. Shamshirsaz; Kamran Hessami; Stephanie Morain; Yalda Afshar; Ahmed A. Nassr; Sara E. Arian; Nazlisadat Meshinchi Asl; Kjersti Aagaard

doi:10.1055/a-1674-6120

American Journal of Perinatology, Table of Contents

Am J Perinatol 2022; 39(05): 492-500
DOI: 10.1055/a-1674-6120

Review Article

Intention to Receive COVID-19 Vaccine during Pregnancy: A Systematic Review and Meta-analysis

Alireza A. Shamshirsaz

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas

,

Kamran Hessami

²Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas

,

Stephanie Morain

³Department of Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas

,

Yalda Afshar

⁴Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, California

,

Ahmed A. Nassr

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas

,

Sara E. Arian

⁵Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas

,

Nazlisadat Meshinchi Asl

⁶Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas

,

Kjersti Aagaard

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas

› Author Affiliations

Abstract

Objective This meta-analysis aimed to assess the level of intent to receive coronavirus disease 2019 (COVID-19) vaccination and demographical factors influencing vaccine uptake among pregnant individuals.

Study Design PubMed, Scopus, and archive/pre-print servers were searched up to May 22nd, 2021. Cross sectional surveys reporting the percentage of the pregnant individuals intending to get a COVID-19 vaccine were considered eligible for meta-analysis. This review was registered with PROSPERO (CRD42021254484). The primary outcome was to estimate the prevalence of COVID-19 vaccination intent among pregnant population. The secondary outcome was to evaluate the factors influencing the intention for vaccination.

Results Twelve studies sourcing data of 16,926 individuals who were identified as pregnant were eligible. The estimated intention for the receipt of COVID-19 vaccine among women who were pregnant was 47% (95% CI: 38–57%), with the lowest prevalence in Africa 19% (95% CI: 17–21%) and the highest in Oceania 48.0% (95% CI: 44.0–51.0%). Uptake of other vaccines (influenza and/or TdaP) during pregnancy was associated with higher rate of intent to receive the COVID-19 vaccine (OR = 3.03; 95% CI: 1.37–6.73; p = 0.006).

Conclusion The intent to receive COVID-19 vaccine is relatively low among women who are pregnant and substantially varies based on the country of residence. In our meta-analysis, intent of women who were pregnant to receive the COVID-19 vaccine was significantly associated with the history of receiving influenza or TdaP vaccine during pregnancy. Given that in every country only a minority of gravidae have received the COVID-19 vaccine, despite known risks of maternal morbidity and mortality with no evidence of risks of vaccination, it highlights the importance of revised approaches at shared decision making and focused public health messaging by national and international advisories.

Key Points

The estimated global intention for COVID-19 vaccination among pregnant women was 47%.
The lowest intention was in Africa and the highest in Oceania.
These findings highlight the importance of public health messaging by by different agencies.

Keywords

COVID-19 - SARS-CoV-2 - vaccine - meta-analysis - pregnancy

Full Text

References

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