COVID-19 Vaccine Acceptance Among Pregnant Women and Mothers of Young Children Results of a Survey in 16 Countries

Background: With the development of multiple effective vaccines, reducing the global morbidity and mortality of COVID-19 will depend on the distribution, and ultimately acceptance, of COVID-19 vaccination. Estimates of global vaccine acceptance among pregnant women and mothers of young children are yet unknown. An understanding of the challenges and correlates to vaccine acceptance will aid the acceleration of vaccine administration within these key populations.Methods: Acceptance of COVID-19 vaccination among pregnant women and mothers of children younger than 18-year-old, as well as potential predictors, were assessed through an online survey. This survey was administered by Pregistry on several online platforms between October 28 and November 18, 2020.Findings: 17,871 total survey responses from 16 countries were obtained. Given a 90% COVID-19 vaccine efficacy, 52·0% of pregnant women (n=2747/5282) and 73·4% of non-pregnant women (n=9214/12562) indicated an intention to receive the vaccine. 69·2% of mothers (n=11800/17054), both pregnant and non-pregnant, indicated an intention to vaccinate their young children. Vaccine acceptance was generally highest in India, the Philippines, and all sampled countries in Latin America; it was lowest in Russia, the United States, and Australia. The strongest predictors of vaccine acceptance included confidence in vaccine safety or effectiveness, worrying about COVID-19, belief in the importance of vaccines to their own country, compliance to mask guidelines, trust of public health agencies, monitoring news media coverage of COVID-19 as well as general vaccine attitude.Interpretations: COVID-19 vaccine acceptance and its predictors among women vary globally. Current acceptance levels of a COVID-19 vaccine among women from the high-income countries included in this study are insufficient to meet the requirements for community immunity. Perceived risk of the virus and the disease, and public trust play key roles shaping the vaccine acceptance and confidence on top of the existing pre-COVID 19 vaccine attitudes.Funding Statement: Human Immunomics Initiative at the Harvard TH Chan School of Public Health;Pregistry, LLCDeclaration of Interests: The authors disclose no potential conflicts of interest.Ethics Approval Statement: The study was classified exempt by the Harvard Longwood Campus Institutional Review Board (HLC IRB) per the regulations found at 45 CFR 46.104(d)(2) on the basis that it poses no greater than minimal risk and that the recorded information cannot readily identify the subject (directly or indirectly). The study protocol was reviewed and approved by the ethical review committee of Harvard Longwood Campus.