A Systematic Review of Population-Based Studies Assessing Knowledge, Attitudes, Acceptance, and Hesitancy of Pregnant and Breastfeeding Women towards the COVID-19 Vaccine
Author:
Gianfredi Vincenza1ORCID, Stefanizzi Pasquale2ORCID, Berti Alessandro1ORCID, D’Amico Marilena1, De Lorenzo Viola1ORCID, Lorenzo Antonio Di2, Moscara Lorenza2, Castaldi Silvana13ORCID
Affiliation:
1. Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy 2. Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy 3. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122 Milan, Italy
Abstract
The anti-SARS-CoV-2 vaccination is recommended for pregnant women due to the high risk of complications. However, pregnancy has been associated with vaccine hesitancy. Our review aims at summarizing the existing literature about anti-SARS-CoV-2 vaccine hesitancy in pregnant and lactating women. The research was conducted on PubMed/MEDLINE, ExcerptaMedica Database (EMBASE), and Scopus, according to PRISMA guidelines. Articles regarding the COVID-19 vaccine’s acceptance and/or refusal by pregnant and lactating women were selected. Only observational, population-based studies were included. The Joanna Briggs Institute quality assessment tools were employed. A total of 496 articles were retrieved, and after the selection process, 21 papers were included in the current analysis. All the included studies were cross-sectional, mostly from Europe and North America. The sample sizes ranged between 72 and 25,111 subjects. All of them included pregnant subjects, except one that focused on breastfeeding women only. Vaccine hesitancy rates ranged from 26% to 57% among different studies. Fear of adverse events and lack of knowledge were shown to be the main drivers of hesitancy. Approximately half of the studies (11/21) were classified as low quality, the remaining (9/21) were classified as moderate, and only one study was classified as high quality. Primigravidae were also shown to be more likely to accept anti-SARS-CoV-2 vaccination. Our findings confirm significant anti-SARS-CoV-2 vaccine hesitancy among pregnant women. Information gaps should be addressed to contain concerns related to adverse events.
Subject
Pharmacology (medical),Infectious Diseases,Drug Discovery,Pharmacology,Immunology
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