COVID-19 Vaccine Acceptance during Pregnancy: Lessons Learned and How to Design the Best Strategy to Increase Vaccination Acceptance in the Future

Objective: The present study aimed to study the vaccination acceptance of COVID-19 vaccine in the Hellenic pregnant population and make a high relative analysis of the factors that contribute to decision-making concerning the acceptance of the vaccine during pregnancy. Findings could be leveraged for improving the vaccination communication strategy to pregnant women to increase the vaccination acceptance rate. Study design: The present study is a prospective cross-sectional study conducted from October 1, 2021 until March 2022 to 800 pregnant women receiving prenatal care at a tertiary University Hospital. Data was gathered through a face-to-face questionnaire and documented via the official vaccination certificate. Results: The vaccination coverage rate was 53.9%. Employment, older age, and higher monthly income were significantly and positively associated with vaccination (p<0.001). Information provided by health professionals (p=0.004) and scientific sites (p=0.028); sufficient knowledge of vaccines were also positively related to vaccination (p<0.001); pediatric vaccination of their children in the family (p=0.003); vaccination against influenza during pregnancy (past: p<0.001 and present pregnancy: p<0.001); and vaccination against pertussis during pregnancy (present pregnancy: p<0.001) were also positively associated with vaccination. Intention to vaccinate their children in the future with all recommended vaccines; belief in the safety of the vaccines; and belief that vaccination protects children from serious diseases were positively related with vaccine acceptance. Reduced vaccination hesitancy due to the pandemic; and fear of severity of COVID-19 infection (p<0.001 in each case) associated also positively with COVID-19 vaccination. Conclusion: In conclusion we need to improve the face-to-face communication with pregnant women, focusing more on safety and effectiveness data, sharing information about surveillance programs, using clinical experience from other maternal vaccination, and presenting the benefits from vaccination to the mother and the offspring.