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Volume 12
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10.3390/vaccines12040440
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Article

Courage in Decision Making: A Mixed-Methods Study of COVID-19 Vaccine Uptake in Women of Reproductive Age in the U.K.

by
Laura A. Magee
1,*,
Julia R. Brown
2,
Vicky Bowyer
2,
Gillian Horgan
1,
Harriet Boulding
3,
Asma Khalil
4,
Nathan J. Cheetham
2,
Nicholas R. Harvey
2,
COVID Symptom Study Biobank Consortium
†,
RESILIENT Study Group
‡,
Hiten D. Mistry
1,
Carole Sudre
5,
Sergio A. Silverio
1,6,
Peter von Dadelszen
1 and
Emma L. Duncan
2
1
School of Life Course & Population Science, King’s College London, London WC2R 2LS, UK
2
Department of Twin Research and Genetic Epidemiology, King’s College London, London SE1 7EH, UK
3
The Policy Institute, King’s College London, London WC2B 6LE, UK
4
Department of Obstetrics and Maternal Fetal Medicine, St. George’s University of London, London SW17 0RE, UK
5
Centre for Medical Image Computer, Department of Computer Science, University College London, London WC1E 6BT, UK
6
School of Psychology, Liverpool John Moores University, Liverpool L3 5AH, UK
*
Author to whom correspondence should be addressed.
†
Membership of the CSSB Study Group is provided in the Supplementary Materials-Table S1.
‡
Membership of the RESILIENT Study Group is provided in the Supplementary Materials-Table S2.
Vaccines 2024, 12(4), 440; https://doi.org/10.3390/vaccines12040440
Submission received: 23 February 2024 / Revised: 3 April 2024 / Accepted: 13 April 2024 / Published: 18 April 2024
(This article belongs to the Special Issue Vaccination with Public Health Perspective: Prevention and Control Strategies)
Versions Notes

Abstract

COVID-19 vaccination rates are lower in women of reproductive age (WRA), including pregnant/postpartum women, despite their poorer COVID-19-related outcomes. We evaluated the vaccination experiences of 3568 U.K. WRA, including 1983 women (55.6%) experiencing a pandemic pregnancy, recruited through the ZOE COVID Symptom Study app. Two staggered online questionnaires (Oct–Dec 2021: 3453 responders; Aug–Sept 2022: 2129 responders) assessed reproductive status, COVID-19 status, vaccination, and attitudes for/against vaccination. Descriptive analyses included vaccination type(s), timing relative to age-based eligibility and reproductive status, vaccination delay (first vaccination >28 days from eligibility), and rationale, with content analysis of free-text comments. Most responders (3392/3453, 98.2%) were vaccinated by Dec 2021, motivated by altruism, vaccination supportiveness in general, low risk, and COVID-19 concerns. Few declined vaccination (by Sept/2022: 20/2129, 1.0%), citing risks (pregnancy-specific and longer-term), pre-existing immunity, and personal/philosophical reasons. Few women delayed vaccination, although pregnant/postpartum women (vs. other WRA) received vaccination later (median 3 vs. 0 days after eligibility, p < 0.0001). Despite high uptake, concerns included adverse effects, misinformation (including from healthcare providers), ever-changing government advice, and complex decision making. In summary, most women in this large WRA cohort were promptly vaccinated, including pregnant/post-partum women. Altruism and community benefit superseded personal benefit as reasons for vaccination. Nevertheless, responders experienced angst and received vaccine-related misinformation and discouragement. These findings should inform vaccination strategies in WRA.
Keywords: vaccination; hesitancy; COVID-19 vaccination; hesitancy; COVID-19

Share and Cite

MDPI and ACS Style

Magee, L.A.; Brown, J.R.; Bowyer, V.; Horgan, G.; Boulding, H.; Khalil, A.; Cheetham, N.J.; Harvey, N.R.; COVID Symptom Study Biobank Consortium; RESILIENT Study Group; et al. Courage in Decision Making: A Mixed-Methods Study of COVID-19 Vaccine Uptake in Women of Reproductive Age in the U.K. Vaccines 2024, 12, 440. https://doi.org/10.3390/vaccines12040440

AMA Style

Magee LA, Brown JR, Bowyer V, Horgan G, Boulding H, Khalil A, Cheetham NJ, Harvey NR, COVID Symptom Study Biobank Consortium, RESILIENT Study Group, et al. Courage in Decision Making: A Mixed-Methods Study of COVID-19 Vaccine Uptake in Women of Reproductive Age in the U.K. Vaccines. 2024; 12(4):440. https://doi.org/10.3390/vaccines12040440

Chicago/Turabian Style

Magee, Laura A., Julia R. Brown, Vicky Bowyer, Gillian Horgan, Harriet Boulding, Asma Khalil, Nathan J. Cheetham, Nicholas R. Harvey, COVID Symptom Study Biobank Consortium, RESILIENT Study Group, and et al. 2024. "Courage in Decision Making: A Mixed-Methods Study of COVID-19 Vaccine Uptake in Women of Reproductive Age in the U.K." Vaccines 12, no. 4: 440. https://doi.org/10.3390/vaccines12040440

APA Style

Magee, L. A., Brown, J. R., Bowyer, V., Horgan, G., Boulding, H., Khalil, A., Cheetham, N. J., Harvey, N. R., COVID Symptom Study Biobank Consortium, RESILIENT Study Group, Mistry, H. D., Sudre, C., Silverio, S. A., von Dadelszen, P., & Duncan, E. L. (2024). Courage in Decision Making: A Mixed-Methods Study of COVID-19 Vaccine Uptake in Women of Reproductive Age in the U.K. Vaccines, 12(4), 440. https://doi.org/10.3390/vaccines12040440

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