COVID-19 vaccine uptake and attitudes among pregnant and postpartum parents

BACKGROUND: Pregnancy poses increased risks from COVID-19, including hospitalization and premature delivery. Yet pregnant individuals are less likely to have received a COVID-19 vaccine. OBJECTIVE: This study aimed to investigate COVID-19 vaccine uptake and reasons for delay or refusal among perinatal parents. STUDY DESIGN: A total of 1542 eligible parents who delivered between 2019 and 2021 were surveyed through the Ovia parenting app, which has a nationally representative user base. Adjusted and nationally weighted means were calculated. Multivariate logistic regression and survival models were used to examine uptake. RESULTS: At least 1 dose of the COVID-19 vaccine was received by 70% of the parents. Those with a bachelor's or graduate degree were significantly more likely to have received a vaccine relative to those with some college or less (adjusted odds ratio for bachelor's degree, 1.854; 95% confidence interval, 1.19–2.90; adjusted odds ratio for graduate degree, 2.833; 95% confidence interval, 1.69–4.75). Parents living in rural areas were significantly less likely to have received a vaccine relative to those living in urban areas (adjusted odds ratio for small city, 0.62; 95% confidence interval, 0.45–0.86; adjusted odds ratio for rural area, 0.56; 95% confidence interval, 0.35–0.89); 56% (281/502) of unvaccinated parents considered that the vaccine “was too new.” Among those pregnant in 2021, 44% (258/576) received at least 1 dose, and 34% (195/576) reported that pregnancy had “no impact” on their vaccine decision. CONCLUSION: There was significant heterogeneity in vaccine uptake and attitudes toward vaccines during pregnancy by sociodemographics and over time. Public health experts need to consider and test more tailored approaches to reduce vaccine hesitancy in this population.