Department of Obstetrics and Gynecology, Tulane University School of Medicine, New Orleans, LA, USA
Background: Although American College of Obstetricians and Gynecologists (ACOG) had dedicated significant efforts to reassure the public regarding vaccination safety during pregnancy, uptake in this vulnerable population remains low. Amid growing scrutiny of vaccination, this study examines COVID-19 vaccine uptake among our pregnant patient population and identifies key factors contributing to hesitancy.
Methods: Between April and July 2021, a prospective observation study was conducted across outpatient clinics affiliated with a New Orleans, LA academic medical center. During prenatal visits, pregnant patients received counseling on risks of COVID-19 infection during pregnancy and the benefits of vaccination. Data on patient demographics, obstetrical characteristics, and perceptions on COVID-19 vaccine were collected. Furthermore, to determine the vaccination acceptance rate in our study population, we checked the Louisiana Immunization Information System (LINKS) to verify vaccination status of those who delivered at our institution and were vaccinated during pregnancy or postpartum between February 2021 and February 2022 (when COVID-19 vaccine became more readily available in the US).
Results: Among 262 women surveyed (mean age 28.6 ± 6.3 years and mean gestational age of 24.7 ± 9.9 weeks), 103 (43.3%) had never been tested for COVID-19, with 18 (7.3%) reporting a pre-pregnancy infection and 8 (3.2%) already had COVID-19 infection during pregnancy. Vaccine hesitancy was primarily driven by safety concerns for themselves (28%) or the fetus (24%). Information sources on COVID-19 vaccine included news media (37.8%), friends/family (30.5%), social media (21.0%), and government sources (6.1%), with only 17.2% relying on healthcare practitioners. While 21.5% were vaccinated prior to the survey, comparison analysis across three racial groups (27.3% Caucasian, 21.3% African American, 14.1% Hispanic) showed no statistical significance. This survey result was supported by data obtained from LINKS from February 2021 to February 2022, which noted low COVID-19 vaccination rates of only 32% (Caucasian), 31% (African American), and 27% (other ethnicities) among obstetrical patients who delivered at our institution over that period.
Conclusion: Despite expecting hesitancy due to the COVID-19 vaccine’s newness, we found that vaccine reluctance among pregnant women is high and consistent across ethnicities. By examining these perceptions and their information sources, we can develop targeted strategies to reduce vaccine hesitancy.
Keywords: COVID-19; Vaccinations in Pregnancy; Vaccine Hesitancy
Chi Dola., et al. “Understanding Vaccine Hesitancy: Risk Perceptions in Pregnant Women during the COVID-19 Pandemic”. EC Gynaecology 15.6 (2026): 01-07.
© 2026 Chi Dola., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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