COVID-19 vaccination rate and factors affecting non-vaccination in pregnant women

Abstract views: 109 / PDF downloads: 110




COVİD-19, vaccination, pregnancy, vaccine hesitancy, perinatal


Examining the Coronavirus disease 2019 (COVID-19) vaccination rates and associated factors for acceptance of vaccination in pregnant women during the pandemic. The present study has a cross-sectional survey-based design that evaluated 448 pregnant women, and data were collected between October 1 and December 31, 2021. A composite questionnaire with an instrument was utilized in the survey to examine vaccine rates, including socio demographic data, maternal characteristics, vaccination history, and reasons for not vaccinating. The vaccination rate was 48% (n=216). The main concerns and barriers to non-vaccination were: (i) concerns about pregnancy (82.9%), (ii) possible vaccine side effects (76.3%), and (iii) insufficient trust in the reliability of the vaccine (20.3%). A multiple logistic regression analysis revealed that following factors affect COVID-19 vaccination rate: first trimester of pregnancy (Odds ratio (OR): 3.40 (95% confidence interval (CI):1.84-6.27), p < 0.001), age 35 and over (OR: 2.96 (95% CI:1.40-6.27), p=0.004), active working status (OR: 4.88 (95% CI:2.57-9.23), p < 0.001). Our study indicated that rates of COVID-19 vaccination are still low in pregnant women. Pregnant females constitute a special vulnerable part of the community. Therefore, targeted communication is needed to raise awareness of vaccine safety in healthcare professionals and pregnant women, and strategies to solve vaccine hesitation. In addition, post-vaccination monitoring is required to collect additional data.


Download data is not yet available.


Jones C, Heath P. Antenatal immunization: Concepts and challenges. Hum Vaccin Immunother. 2014;10:2118–22. doi: 10.4161/hv.29610.

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 on behalf of the PregCOV-19 Living Systematic Review Consortium. BMJ. 2020;370:3320. doi: 10.1136/bmj.m3320.

Rasmussen SA, Kelley CF, Horton JP, Jamieson DJ. Coronavirus disease 2019 (COVID-19) vaccines and pregnancy: What obstetricians need to know. Obstet Gynecol. 2021;137(3):408-14. doi: 10.1097/AOG.0000000000004290.

Nir O, Schwartz A, Toussia-Cohen S, Leibovitch L, Strauss T, Asraf K, et al. Maternal-neonatal transfer of SARS-CoV-2 immunoglobulin G antibodies among parturient women treated with BNT162b2 messenger RNA vaccine during pregnancy. Am J Obstet Gynecol MFM. 2022;4(1):100492. doi: 10.1016/j.ajogmf.2021.100492.

Kasehagen L, Byers P, Taylor K, Kittle T, Roberts C, Collier C, et al. COVID-19 – Associated deaths after SARS-CoV-2 infection during pregnancy. MMWR Morb Mortal Wkly Rep. 2021;70(47):1646-8. doi: 10.15585/mmwr.mm7047e2.

Goncu Ayhan S, Oluklu D, Atalay A, Menekse Beser D, Tanacan A, Moraloglu Tekin O, et al. COVID-19 vaccine acceptance in pregnant women. Int J Gynaecol Obstet. 2021;154(2):291-6. doi: 10.1002/ijgo.13713.

LaCourse S, John-Stewart G, Waldorf KMA.Importance of inclusion of pregnant and breastfeeding women in covid-19 therapeutic trials. Clin Infect Dis. 2020;71(15):879–81. doi: 10.1093/cid/ciaa444.

Dooling K, McClung N, Chamberland M, Marin, M, Wallace M, Bell BP, et al. The advisory committee on immunization practices’ interim recommendation for allocating initial supplies of COVID-19 vaccine-United States, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(49):1857-9. doi: 10.15585/mmwr.mm6949e1.

Kaya O. COVID-19 aşıları. SDÜ Tıp Fakültesi Derg. 2021;28(COVID-19 Özel Sayı):31-5. doi: 10.17343/sdutfd.9050593.

Supangat Sakinah EN, Nugraha MY, Qodar TS, Mulyono BW, Tohari AI. COVID-19 vaccines programs: Adverse events following immunization (AEFI) among medical clerkship student in Jember, Indonesia. BMC Pharmacol Toxicol. 2021;22(1):1-7. doi: 10.1186/s40360-021-00528-4.

Nugraha J, Permatasari CA, Fitriah M, Tambunan BA, Fuadi MR. Kinetics of anti-SARS-CoV-2 responses post complete vaccination with coronavac: A prospective study in 50 health workers. J Public Health Res. 2022;11(3):227990362211041. doi: 10.1177/22799036221104173.

Chi WY, Li YD, Huang HC, Chan, TEH, Chow SY, Su JH, Wu TC, et al. COVID-19 vaccine update: Vaccine effectiveness, SARS-CoV-2 variants, boosters, adverse effects, and immune correlates of protection. J Biomed Sci. 2022;29(1):1-27. doi: 10.1186/s12929-022-00853-8.

Safadi MA, Spinardi J, Swerdlow D, Srivastava A. COVID‐19 disease and vaccination in pregnant and lactating women. Am J Reprod Immunol. 2022;88(1):e13550. doi: 10.1111/aji.13550.

Oncel MY. Akın IM, Kanburoglu MK, Tayman C, Coskun S, Narter F, et al. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr. 2021;180:733-42. doi: 10.1007/s00431-020-03767-5.

Litman EA, Yin Y, Nelson SJ, Capbarat E, Kerchner D, Ahmadzia HK. Adverse perinatal outcomes in a large United States birth cohort during the COVID-19 pandemic. Am J Obstet Gynecol MFM. 2022;4(3):100577. doi: 10.1016/j.ajogmf.2022.100577.

Chinn J, Sedighim S, Kirby KA, Hohmann S, Hameed AB, Jolley J, et al. Characteristics and outcomes of women with COVID-19 giving birth at US academic centers during the COVID-19 pandemic. JAMA Network. 2021;4(8):e2120456. doi: 10.1001/jamanetworkopen.2021.20456.

Carbone L, Di R, Mappa I, Saccone G, Raffone A, Di D, et al. Worldwide beliefs among pregnant women on SARS-CoV-2 vaccine: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2020;268:144-64. doi: 10.1016/j.ejogrb.2021.12.003.

Lazarus JV, Ratzan SC, Palayew A, Gostin LO, Larson HJ, Rabin K, et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med. 2021;27(2):225-8. doi: 10.1038/s41591-020-1124-9.

Polat G, Sağlam ZA, Polat İ, Yücel B. Gebelikte COVID-19 aşılamasını etkileyen hasta faktörleri: Bir anket çalışması (in Turkish). İKSSTD 2022;14(2):170-5. doi: 10.14744/iksstd.2022.31644.

Skjefte M, Ngirbabul M, Akeju O, Escudero D, Hernandez-Diaz S, Wyszynski DF, et al. COVID-19 vaccine acceptance among pregnant women and mothers of young children: Results of a survey in 16 countries. Eur J Epidemiol 2021;36:197-211. doi: 10.1007/s10654-021-00728-6.

Bradshaw AS, Shelton SS, Wollney E, Treise D, Auguste K. Pro-Vaxxers get out: Antivaccination advocates influence undecided first time, pregnant, and new mothers on Facebook. Health Commun. 2021;36(6):693-702. doi: 10.1080/10410236.2020.1712037.

Garg I, Shekhar R, Sheik AB, Pal S. COVID-19 vaccine in pregnant and lactating women: A review of existing evidence and practice guidelines. Infect Dis Rep. 2021;13(3):685-99. doi: 10.3390/idr13030064.

Zauche LH, Wallace B, Smoots AN, Olson CK, Oduyebo T, Kim SY, et al. Receipt of mRNA Covid-19 vaccines and risk of spontaneous abortion. N Engl J Med. 2021;385(16):1533-5. doi: 10.1056/NEJMc2113891.

Kharbanda EO, Haapala J, DeSilva M, Vazquez-Benitez G, Vesco KK, Naleway AL, et al. Spontaneous abortion following COVID-19 vaccination during pregnancy. JAMA. 2021;326(16):1629-31. doi: 10.1001/jama.2021.15494.

Shimabukuro TT, Kim SY, Myers TR, Moro PL, Oduyebo T, Panagiotakopoulos L, et al. Preliminary findings of mRNA Covid-19 vaccine safety in pregnant persons. N Engl J Med. 2021;384(24):2273-82. doi: 10.1056/NEJMoa2104983.

Centers for Disease Control and Prevention (CDC).V-safe COVID-19 vaccine pregnancy registry. Retrieved from,be%20enrolled%20in%20v%2Dsafe. (Accessed Date: 15 May 2022).

Ceulemans M, Foulon V, Panchaud A, Winterfeld U, Pomar L, Lambelet V, et al. Vaccine willingness and impact of the COVID-19 pandemic on women’ s perinatal experiences and practices- a multinational , cross-sectional study covering the first wave of the pandemic 2021. Int J Environ Res Public Health. 2021;18(7):3367. doi: 10.3390/ijerph18073367.

Mappa I, Luviso M, Distefano FA, Carbone L, Maruotti GM, Rizzo G. Women perception of SARS-CoV-2 vaccination during pregnancy and subsequent maternal anxiety: A prospective observational study. J Matern Fetal and Neonatal Med. 2021;35(25):1-4. doi: 10.1080/14767058.2021.1910672.

Mose A, Yeshaneh A. COVID-19 vaccine acceptance and its associated factors among pregnant women attending antenatal care clinic in southwest ethiopia: Institutional-based crosssectional study. Int J Gen Med. 2021;14:2385-95. doi: 10.2147/IJGM.S314346.

Stuckelberger S, Favre G, Ceulemans M, Nordeng H, Gerbier E, Lambelet V, et al. Sars-cov-2 vaccine willingness among pregnant and breastfeeding women during the first pandemic wave: A cross-sectional study in Switzerland. Viruses. 2021;13(7):1-13. doi: 10.3390/v13071199.

Gencer H, Özkan S, Vardar O. The effects of the COVID 19 pandemic on vaccine decisions in pregnant women. Women Birth. 2022;35(3):317-23. doi: 10.1016/j.wombi.2021.05.003.

Mohan S, Reagu S, Lindow S, Alabdulla M. COVID-19 vaccine hesitancy in perinatal women: A cross sectional survey. J Perinat Med. 2021;49(6):678-85. doi: 10.1515/jpm-2021-0069.

Carbone L, Mappa I, Sirico A, Girolamo DR, Saccone G, Mascio DD, et al. Pregnant women’s perspectives on severe acute respiratory syndrome coronavirus 2 vaccine. Am J Obstet Gynecol MFM. 2021;3(4):100352. doi: 10.1016/j.ajogmf.2021.100352.

Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in adults aged 65 years and older- Advisory Committee on Immunization Practices (ACIP), 2012. MMWR Morb Mortal Wkly Rep. 2012;61(25):468-70. (Accessed Date: 15 May 2022)




How to Cite

Ersoy, P., & Korkmaz, D. (2023). COVID-19 vaccination rate and factors affecting non-vaccination in pregnant women. HEALTH SCIENCES QUARTERLY, 3(2), 95–104.



Original Article

Most read articles by the same author(s)