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31 Jan 2023

Why are some women unsure or not intending to get the COVID vaccine?

Low vaccine confidence in women of childbearing age is driving lower vaccination rates for this group, compared to the overall Australian population, despite growing evidence of COVID-19 vaccine safety and the effectiveness of mRNA vaccines for pregnant and non-pregnant women.

With pregnant women and newborns at higher risk of severe outcomes from COVID-19 disease,[¹] understanding why some women are unsure or not intending to be vaccinated is key to increasing COVID-19 vaccine uptake and prevent negative COVID-19 outcomes.

In an Australian first, researchers from The Peter Doherty Institute for Infection and Immunity (Doherty Institute) and Murdoch Children’s Research Institute (MCRI) explored the main factors influencing decision-making for COVID-19 vaccines, focusing on the perspectives of pregnant and breastfeeding women.  

The in-depth study uncovered six key themes: weighing up perceived risks for self and baby; availability of information; change and contradictions; vaccination above everything; practical issues – hurdles of inconvenience. 

Dr Jane Oliver, a Postdoctoral Research Fellow at the Doherty Institute and MCRI, is a public health researcher with a strong interest in infectious disease epidemiology, and lead author of the research published in Vaccine X.

“Our analysis showed that concerns about safety in pregnancy and breastfeeding, questions on the effects on fertility, and loss of trust in healthcare providers following vaccine mandates were driving many women aged 18-40 years to forgo or delay COVID-19 vaccination,” Dr Oliver says.

“Public health campaigns and communications should be tailored to address these specific concerns to increase COVID-19 vaccine uptake in this group.”

The research highlights the need for robust safety data across fertility, birth outcomes and child development following COVID-19 vaccination to effectively address lower vaccine confidence in this cohort.

Other considerations include the provision of family-friendly vaccination environments, with increased childcare access, and strategies to build trust with healthcare providers in order to boost COVID-19 vaccine uptake and improve health outcomes for pregnant women and their infants.

Peer review: Vaccine X
Funding: The Women’s Vaccine Decisions and COVID-19 Study was jointly funded through a charitable donation from the Prior Family Foundation and the Optimise Study (which was funded by the Victorian Department of Health, the Macquarie Group and the Burnet Institute). 

[¹] Allotey J, Fernandez S, Bonet M, Stallings E, Yap M, Kew T et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis BMJ 2020; 370 :m3320 doi:10.1136/bmj.m3320