COVID-19 vaccine uptake and hesitation among men and women preparing for pregnancy: a cross-section survey based on the theory of planned behavior

BACKGROUND: Given the accelerated speed of COVID-19 vaccine research and administration, the main barriers to herd immunity appear to be concerns about safety and efficacy. Men and women preparing for pregnancy may have the same concerns about COVID-19 vaccination, but few studies have focused on COVID-19 vaccine uptake and hesitation among them. METHODS: A cross-sectional study was conducted among men and women who were preparing for pregnancy in Southwest China. The questionnaire was designed based on the theory of planned behavior (TPB). Multiple logistic regression was used to explore the determinants of the behaviors of COVID-19 vaccination. RESULTS: A total of 2878 participants completed the survey. A total of 53.89% of participants received at least one dose of the COVID-19 vaccine. A total of 45.21% of participants would receive the COVID-19 vaccine in the future. A total of 0.90% of participants never thought about receiving the COVID-19 vaccine. Multiple logistic regression model 1 showed that female participants (OR:5.497, 95%CI: 4.292–7.041), participants who never received influenza vaccine (OR:2.664, 95%CI: 1.908–3.718), participants who had never been tested for COVID-19 (OR:2.244, 95%CI:1.504–3.349), participants who had higher score of negative attitude (OR:1.448, 95%CI: 1.219–1.719), participants who had lower scores of injunctive norms (OR:0.440, 95%CI: 0.360–0.537) and descriptive norms (OR:0.105, 95%CI: 0.088–0.126) were more likely to delay COVID-19 vaccination. Model 2 showed that participants who had lower scores for positive attitude (OR: 0.406, 95% CI: 0.230–0.716), injunctive norms (OR: 0.283, 95% CI: 0.130–0.614) and descriptive norms (OR: 0.060, 95% CI: 0.038–0.094) were more likely to refuse COVID-19 vaccination. CONCLUSIONS: The COVID-19 vaccination rate of men and women preparing for pregnancy was significantly lower than the average vaccination rate of China. Gender, protective health behaviors, vaccination attitudes, and subjective norms had effects on the vaccination behaviors of couples preparing for pregnancy.