Association between social vulnerability and COVID-19 vaccination hesitancy and vaccination in pregnant and postpartum individuals. Issue 44 (19th October 2022)

• Record Type: Journal Article
• Authors: Kiefer, Miranda K.; Mehl, Rebecca; Rood, Kara M.; Germann, Katherine; Mallampati, Divya; Manuck, Tracy; Costantine, Maged M.; Lynch, Courtney D.; Grobman, William A.; Venkatesh, Kartik K.
• Is Part Of: Vaccine. Volume 40:Issue 44(2022)
• Page Start: 6344
• Page End: 6351
• Publication Date: 2022-10-19
• Subjects: COVID-19 -- Maternal immunization -- Pregnancy -- Vaccine uptake -- Vaccine hesitancy -- Social vulnerability; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2022.09.045
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: Social Vulnerability Index measures community-level social vulnerability. COVID19 vaccine hesitancy is increased with higher social vulnerability in pregnancy. SVI may be used to target vaccine interventions, but further study is needed. Abstract: Objective: To evaluate the association of community-level social vulnerability with COVID-19 vaccine hesitancy and vaccination among pregnant and postpartum individuals. Methods: Prospective cohort study assessing COVID-19 vaccine hesitancy among pregnant and postpartum individuals. We performed a baseline survey on COVID-19 vaccine hesitancy from 03/22/21 to 04/02/21, and a follow-up survey on COVD-19 vaccination status 3- to 6-months later. The primary exposure was the Centers for Disease Control and Prevention SVI (Social Vulnerability Index), measured in quartiles. Higher SVI quartiles indicated greater community-level social vulnerability with the lowest quartile (quartile 1) as the referent group. The primary outcome was COVID-19 vaccine hesitancy on the baseline survey (uncertainty or refusal of the vaccine), and the secondary outcome was self-report of not being vaccinated (unvaccinated) for COVID-19 on the follow-up survey. Results: Of 456 assessed individuals, 46% reported COVID-19 vaccine hesitancy on the baseline survey; and of 290 individuals (290/456, 64%) who completed the follow-up survey, 48% (140/290) were unvaccinated. The frequency of baseline vaccine hesitancy ranged from 25% in quartile 1 (low SVI) to 68% in quartile 4 (high SVI), and being unvaccinated at follow-up ranged from 29% in quartile 1 to 77% in quartile 4. As social vulnerability increased, the risk of COVID-19 vaccine hesitancy at baseline increased (quartile 2 aRR (adjusted relative risk): 1.46; 95% CI:0.98 to 2.19; quartile 3 aRR: 1.86; 95% CI:1.28 to 2.71; and quartile 4 aRR: 2.24; 95% CI:1.56 to 3.21), as did the risk of being unvaccinated at follow-up (quartile 2 aRR: 1.00; 95% CI:0.66 to 1.51; quartile 3 aRR: 1.68; 95% CI:1.17 to 2.41; and quartile 4 aRR: 1.82; 95% CI:1.30 to 2.56). Conclusions: Pregnant and postpartum individuals living in an area with higher community-level social vulnerability were more likely to report COVID-19 vaccine hesitancy and subsequently to be unvaccinated at follow-up.