Vaccination plays an important role to end the pandemic, without the exception of the coronavirus disease 2019 (COVID-19) pandemic. Hence, vaccine acceptance is essential. It is an individual preference to accept or refuse once given chance to get vaccinated. This systematic study focuses on pregnant women which are in a high-risk group for infection with Covid-19 and influenza. Influenza vaccination is used to prevent co-infection against COVID-19. This study discussed the acceptance of the COVID-19 vaccine by pregnant women based on factors: concerns about COVID-19 infection and history of influenza vaccination.
The importance of vaccination against COVID-19 for pregnant women
Pregnant women are at a higher risk for severe illnesses. Morbidity and mortality rates in pregnant women with COVID-19 were recorded to be higher than the rate without COVID-19 (31.9%) appertaining higher rates of hypertension due to pregnancy, preeclampsia/eclampsia, infections that required antibiotics, and higher risk of the patient admitted to the intensive care unit (ICU). The condition of COVID-19-infected pregnant women may increase the risk of preterm birth, stillbirth, and other pregnancy complications. On the other hand, COVID-19 vaccination during pregnancy provides benefits for the mother and child. The immune response induced by the COVID-19 vaccine was significantly higher than the natural immune response due to severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection during pregnancy. The transfer of antibodies produced by vaccines was also detected in neonates through placental and mother’s milk. A preliminary study also suggested that the mRNA vaccine is safe for pregnant women. Therefore, COVID-19 vaccination is important for pregnant women. However, the acceptance rate of COVID-19 vaccination is not always high. Vaccine refusal on pregnant women is impacting the formation of herd immunity. Due to the fatal consequence of vaccine refusal and hesitancy, it is important to identify the factors contributing to the low acceptance of vaccines to be acknowledged and intervened comprehensively.
Perception of risk of similar disease influences the perception of COVID-19 infection.
The risk and threat of COVID-19 are perceived to be equal to bird flu infection and severe acute respiratory syndrome. Perceptions about the risk of being infected with COVID-19 were reported to be higher in women than men, so it is suspected to be the cause of the high score of knowledge tests about COVID-19 in women.
Factors affecting COVID-19 vaccination acceptance on pregnant women
Our systematical study resulted as follows
Characteristics of pregnant women who accepted the COVID-19 vaccination
Young pregnant women tend to understand the updates about COVID-19 which shows higher acceptance of COVID-19 vaccination. The educational levels of the respondents who showed higher COVID-19 vaccine acceptance were high school or higher. This is understandable as pregnant women with higher knowledge are likely to know more about COVID-19 and the severity of the virus in themselves and their fetuses, so they can easily accept the COVID-19 vaccine. The respondents who were likely to accept the COVID-19 vaccine were housewives. Pregnant women from lower socio-economic classes are more likely to receive COVID-19 vaccinations.
Concerns about being infected with COVID-19 among pregnant women
Mothers with their first pregnancy during the COVID-19 pandemic, under the age of 30 years, working and having a history of previous abortions showed a higher level of concern about being infected with COVID-19. In China, young pregnant women are more likely to follow social media and updates regarding the impact of the COVID-19 virus on the general population and its risks, thus indicating a higher level of concern about the effect of COVID-19 on the general population and its risks. Conversely, in Southwest Ethiopia, pregnant women aged 34-41 years and over were more likely to accept the COVID-19 vaccine due to the more fatal complications of the COVID-19 virus in the elderly population. The concerns affect pregnant women’s well-being. Therefore, it is recommended to form a support group for pregnant women during the COVID-19 pandemic to help overcome their concerns and increase awareness of COVID-19, especially for pregnant women with low levels of anxiety who may tend to underestimate the risk during this pandemic.
People’s perception of the vulnerability and benefit of the COVID-19 vaccine affects their willingness to get vaccinated. Pregnant women who were worried to get COVID-19 were more likely to accept the vaccine. Besides, respondents were more likely to get vaccinated when they were sure that the COVID-19 risks, infection to others, and complication risks could be reduced by the vaccine.
The relation between acceptance of the COVID-19 vaccine and concerns about being infected with COVID-19 should not be used to increase fear among the population to increase vaccine acceptance. Excessive fear and emotional attitude toward the pandemic will become the risk factors for more severe mental health problems and the inability to take appropriate and adaptive prevention measures. Therefore, a better suggestion is the use of risk communication strategies by increasing public perception of risk and severity and promoting prevention and therapy in overcoming some fears and concerns about COVID-19, especially among those who consider the disease to be harmless. The increased perception of risk related to the COVID-19 pandemic will lead individuals to engage in risk aversion behavior and emphasize the adaptive role of anxiety. For instance, keeping a safe distance from people, avoiding crowds, staying home, and higher acceptance of the COVID-19 vaccine were carried out in individuals with high levels of COVID-19-related anxiety as an adaptive anxiety response. One of the steps that can be taken is circulating credible information by health workers as health promoters or educators in dealing with COVID-19 as well as forging critical health literacy and digital health literacy.
It is advisable for social media users to always confirm the truth of the information by validating the source of information, reading the given information completely, confirming the author, doing an in-depth investigation of the written data of the information, recognizing if there are fake images, and looking for other sources or asking a professional when doubting the information validity. The government’s role in eradicating hoaxes can be done by issuing appeals regarding COVID-19, holding press conferences, advertising preventive campaigns, and making regulations and fines regarding distributing wrong and misleading information. In addition, the government’s role in creating a national consensus on the importance of public health measures, including wearing face masks and mass vaccination to end the COVID-19 pandemic crisis, is needed to build confidence in COVID-19 vaccination.
History of influenza vaccination in pregnant women
A study reported that pregnant women who got influenza vaccination were more likely to accept COVID-19 vaccinations.
Confidence and the public’s trust in government
The average COVID-19 vaccination acceptance rate exceeds 80% in Asian countries with a firm trust in the government, such as China (nearly 90%), South Korea, and Singapore. Approximately 83.7% of Chinese respondents answered that they would accept COVID-19 vaccination by their superiors’ recommendation at work and if declared safe and effective by the government. People who receive seasonal influenza vaccination were likely to accept the COVID-19 vaccine as the experience makes them more confident.
The concern of COVID-19 infection should be the main focus of the intervention and treatment to improve the acceptance of COVID-19 vaccination for pregnant women. Steps that can be taken are to increase the perception of risk and severity and to promote prevention and therapy against COVID-19. The role of health workers and the government is needed to build trust in COVID-19 vaccination with clear and integrated communication using social media, electronic and printed media, text messages, telephone, direct communication, etc. In addition, the government needs to pay attention to preventing the spread of false and misleading information by holding press conferences, preventive campaign advertisements and making regulations and fines regarding the distribution of wrong information
Authors: Chiquita Febby Pragitara, Naomi Rahmasena, Ayuning Tetirah Ramadhani, Sarah Fauzia, Reyna Erfadila, Dadang Mutha Wali Faraj, Diah Caesaria Garindra Ramadhanti, Samsriyaningsih Handayani
Source: https://ijphs.iaescore.com/index.php/IJPHS/article/view/21187
