Pregnant people are faced with many opinions and competing ideas about what’s best for them and their unborn children. The pandemic has only made things more complicated for expecting parents, as they’ve had to grapple with challenging decisions, often with conflicting information. One such decision is when to receive one of the COVID-19 vaccines currently authorized for all people aged 12 and older in the United States. 

To better understand what’s guiding the decision-making of unvaccinated pregnant people, Maven commissioned a survey of 500 nationally representative U.S.-based pregnant people to shed light on their perceptions of the vaccine, how they’re making decisions about getting vaccinated, and whether they plan to receive a shot—now or in the future.

The clinical guidance to date

Although pregnant people are at higher risk of serious illness from COVID-19, data show they are less likely to receive the vaccine than non-pregnant Americans: as of October 16, 2021, just 26% of pregnant people received at least one dose of the vaccine, compared to 66% of adults nationwide. This disparity comes despite clinical guidance strongly recommending the vaccine during pregnancy based on existing evidence that vaccination prevents risk of serious illness and protection also passes to unborn children. 

In July, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM), the preeminent professional membership organizations guiding obstetric care, issued a strong recommendation in support of vaccination during pregnancy. In September, after the deadliest month on record for pregnant people as a result of COVID-19 infection, the CDC issued its strongest guidance to date, urging people who are currently pregnant, recently pregnant, or trying to become pregnant to receive the vaccine.

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Key findings from the survey

1. Most pregnant people do not know the CDC recommends vaccines during pregnancy

61% of respondents were unaware of the latest CDC guidance recommending vaccines for people who are pregnant, recently pregnant, trying to become pregnant, or may be pregnant in the future.

2. Pregnant people are receiving misinformation about vaccine safety from a broad array of sources, including but not limited to the medical community

Pregnant people get their advice from a variety of sources with competing opinions, including the medical community, family, and friends. Nearly 70% of respondents said at least one source suggested they avoid receiving the COVID vaccine. 53% said family and friends advised against the vaccine, and nearly one third (29%) said a medical provider advised against receiving the vaccine.

3. The majority of unvaccinated pregnant people do not plan to get vaccinated during their pregnancy

68% of respondents said they don’t plan to receive the vaccine while pregnant. 36% of respondents said they don’t plan to ever get the vaccine, and 32% said they plan to get the vaccine after giving birth. Nationally, only 13% of Americans do not plan to get vaccinated.

4. The most important factor pregnant people take into account when deciding to get vaccinated is the health and safety of their baby.

Pregnant people who decide not to get the vaccine are typically doing so with the health and safety of their baby in mind. 61% cited their unborn child’s health as the primary reason why they did or did not receive a COVID-19 vaccine, and 28% felt that there was a lack of sufficient information on the effects of the vaccine.

How to improve vaccination rates? Start with empathy

To help make sense of these findings and identify methods for improving vaccination rates, we turned to Dr. Neel Shah, MD, MPP, FACOG, Maven’s Chief Medical Officer: “Pregnant people want to do what is safest for them and their baby. For many people, there is not a single source of truth,” he said. “We need trustworthy and accurate messaging from a broad array of sources—and we need to meet people where they are by truly listening to their concerns."

That means having empathy for pregnant people who are hesitant to get the vaccine is a crucial first step. To help pregnant people make informed decisions, those concerned with their health and wellbeing — including providers, loved ones, and friends — should strive to listen to their reservations without judgment. 

The health care system often imposes barriers for pregnant people in seeking out medical advice. Between the difficulty of securing an in-person visit with a provider to concerns over cost (studies repeatedly show Americans forego necessary medical care to save money), it can be hard for pregnant people to get reliable information from a provider they can trust. 

To help remove those barriers, Maven is making our network of OB-GYNs and midwives available for free appointments for any pregnant person seeking guidance on vaccination and pregnancy. As always, those with employer or payer-sponsored membership can speak with any of our providers at no cost.

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