COVID-19 Vaccination during Pregnancy and Lactation: Attitudes and Uptakes before and after Official Recommendations in Germany
Abstract
:1. Introduction
2. Methods
2.1. Materials and Procedure
2.2. Measures
2.3. Statistical Analysis
3. Results
3.1. Participant Characteristics
3.2. Vaccination Recommendation Awareness
3.3. Pregnant Women’s Attitudes towards COVID-19 Vaccination
3.3.1. Results from the Second Survey after the National Recommendation
3.3.2. Comparison before and after the Official Recommendation
3.4. Breastfeeding Women’s Attitudes towards COVID-19 Vaccination
3.4.1. Results from the Second Survey after the National Recommendation
3.4.2. Comparison before and after Official Recommendation
3.5. Identification of General COVID-19 Vaccination Opponents
4. Discussion
4.1. Vaccination Prevalence
4.2. Reasons for and against Vaccination
4.3. Knowledge Transfer and Dissemination of the Official Recommendation
4.4. The Role of Health Care Professionals
4.5. Vaccination Opponents
4.6. Clinical Implications
4.7. Strengths and Limitations
4.8. Research Implications
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Before Official Recommendation (n = 2339) | After Official Recommendation (n = 3072) | |||
---|---|---|---|---|
Pregnant Women | Breastfeeding Women | Pregnant Women | Breastfeeding Women | |
n | 1043 | 1296 | 1281 | 1791 |
Age (years) | 31.8 ± 4.3 | 32.4 ± 4.4 | 30.8 ± 4.0 (20–46) | 31.7 ± 4.3 |
Age distribution (n) | ||||
≤24 y | 48 | 47 | 58 | 65 |
25–39 y | 959 | 1172 | 1189 | 1652 |
≥40 y | 36 | 77 | 34 | 74 |
Medical condition with higher risk for COVID-19 | 210 (20.1%) | 262 (20.2%) | 198 (15.5%) | 207 (11.5%) |
SARS-CoV-2 positive previously | 44 (4.2%) | 45 (3.7%) | 96 (7.5%) | 106 (5.9%) |
COVID-19 symptoms
| 6 (13.6%) 30 (68.2%) 8 (18.2%) - | 5 (11.1%) 35 (77.8%) 5 (11.1%) - | 8 (8.3%) 61 (63.5%) 25 (26%) 2 (2.1%) | 4 (3.8%) 80 (75.5%) 20 (18.9%) 2 (1.9%) |
Fear of COVID-19 symptoms (VAS *; mm) | 57.12 ± 27.09 | 55.14 ± 26.60 | 54.1 ± 27.0 | 54.2 ± 26.1 |
Fear of SARS-CoV-2 infection (VAS *; mm) | 51.18 ± 25.55 | 48.06 ± 24.53 | 52.1 ± 25.0 | 50.6 ± 24.5 |
Gestational age (weeks) | 24.7 ± 9.1 | - | 26.2 ± 9.5 (4–42) | - |
1. Trimester | 12% (116/966) | 8.4% (108/1279) | ||
2. Trimester | 34% (330/966) | 34.5% (442/1279) | ||
3. Trimester | 53.8% (520/966) | 57.0% (729/1279) | ||
First pregnancy | 494 (47.4%) | - | 804 (63%) | - |
High-risk pregnancy | 418 (40.1%) | - | 401 (31.1%) | - |
COVID-19 vaccination | ||||
| 1018 (97.6%) 25 (2.4%) 1 dose 13 (52%) 2 doses 12 (48%) | 1108 (85.5%) 188 (14.5%) During pregnancy 2 (1.1%) Post-partum 186 (98.9%) | 529 (41.3%) 752 (58.7%) 1 dose 86 (11.4%) 2 doses 660 (87.8%) 3 doses 6 (0.8%) | 452 (25.3%) 1339 (74.8%) During pregnancy 453 (33.8%) Post-partum 1116 (83.3%) |
Before Official Recommendation n = 2339 | After Official Recommendation n = 3072 | p-Values | Effect Size ϕ | |
---|---|---|---|---|
Pregnant women’s reason for vaccination | ||||
Professional reason | 88.0% (22/25) | 31.3% (235/752) | <0.001 | 0.213 |
More fear of infection than of vaccination side effects | 52.0% (13/25) | 66.2% (498/752) | 0.052 | . |
High risk for COVID-19 | 16.0% (4/25) | 12.4% (93/752) | 0.589 | |
Societal reasons | 12.0% (3/25) | 26.1% (196/752) | 0.113 | |
Protection of the unborn child and myself | 36.0% (9/25) | 62.9% (473/752) | 0.003 | 0.098 |
High SARS-CoV-2 exposure | 20.0% (5/25) | 15.3% (115/752) | 0.522 | |
Official STIKO recommendation | n/a | 15.7% (118/752) | - | |
Pregnant women’s reason against vaccination | ||||
Limited information about vaccination during pregnancy | 53.5% (229/430) | 24.4% (54/221) | 0.001 | 0.275 |
Not enough scientific data for vaccination during pregnancy | 88.1% (379/430) | 82.8% (183/221) | 0.062 | |
No contact person to ask about the vaccination | 8.8% (38/430) | 1.8% (4/221) | 0.006 | 0.135 |
Fear of harm to the unborn child | 87.9% (378/430) | 88.7% (196/221) | 0.770 | |
Fear of pregnancy complications | 80.2% (345/430) | 76.5% (169/221) | 0.265 | |
Fear of side effects | 31.2% (134/430) | 41.6% (92/221) | 0.032 | 0.104 |
Before Official Recommendation | After Official Recommendation | p-Values | Effect Size ϕ | |
---|---|---|---|---|
Breastfeeding women’s reason for vaccination | ||||
Professional reason | 78.3% (148/189) | 14.7% (197/1339) | <0.001 | 0.501 |
More fear of infection than of vaccination side effects | 62.4% (118/189) | 67.0% (897/1339) | 0.241 | |
High risk for COVID-19 | 13.8% (26/189) | 7.6% (102/1339) | 0.012 | 0.073 |
Societal reasons | 29.1% (55/189) | 37.6% (502/1339) | 0.048 | 0.058 |
Protection of my child and myself | 75.1% (142/189) | 89.1% (1193/1339) | <0.001 | 0.138 |
High SARS-CoV-2 exposure | 31.2% (59/189) | 7.1% (95/1339) | <0.001 | 0.264 |
Official STIKO recommendation | n/a | 46.3% (619/1338) | - | |
Breastfeeding women’s reason against vaccination | ||||
Limited information about vaccination during lactation | 53.4% (141/264) | 17.8% (26/146) | <0.001 | 0.347 |
Not enough scientific data for vaccination during lactation | 83.7% (221/264) | 52.1% (76/146) | <0.001 | 0.339 |
No contact person to ask about the vaccination | 11.7% (31/264) | 4.1% (6/146) | 0.03 | 0.128 |
Fear of harm to the child | 67.4% (178/264) | 53.4% (78/146) | 0.02 | 0.138 |
Fear of breastfeeding complications | 24.2% (64/264) | 28.8% (42/146) | 0.316 | |
Fear of side effects | 37.5% (99/264) | 37.7% (55/146) | 0.973 |
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Hagenbeck, C.; Zöllkau, J.; Helbig, M.; Fehm, T.; Schaal, N.K. COVID-19 Vaccination during Pregnancy and Lactation: Attitudes and Uptakes before and after Official Recommendations in Germany. Vaccines 2023, 11, 627. https://doi.org/10.3390/vaccines11030627
Hagenbeck C, Zöllkau J, Helbig M, Fehm T, Schaal NK. COVID-19 Vaccination during Pregnancy and Lactation: Attitudes and Uptakes before and after Official Recommendations in Germany. Vaccines. 2023; 11(3):627. https://doi.org/10.3390/vaccines11030627
Chicago/Turabian StyleHagenbeck, Carsten, Janine Zöllkau, Martina Helbig, Tanja Fehm, and Nora K. Schaal. 2023. "COVID-19 Vaccination during Pregnancy and Lactation: Attitudes and Uptakes before and after Official Recommendations in Germany" Vaccines 11, no. 3: 627. https://doi.org/10.3390/vaccines11030627
APA StyleHagenbeck, C., Zöllkau, J., Helbig, M., Fehm, T., & Schaal, N. K. (2023). COVID-19 Vaccination during Pregnancy and Lactation: Attitudes and Uptakes before and after Official Recommendations in Germany. Vaccines, 11(3), 627. https://doi.org/10.3390/vaccines11030627