Overview
This study examined COVID-19 vaccine uptake, attitudes, and experiences among women of reproductive age in the U.K., highlighting high vaccination rates but also concerns and complex decision-making, especially during pregnancy.
Background & Study Design
- Women of reproductive age (WRA), especially pregnant/postpartum, had lower COVID-19 vaccination rates despite higher health risks.
- The study used two surveys (2021, 2022) among 3568 WRA, including many with pandemic pregnancies, recruited via the ZOE COVID Symptom Study app.
- Both quantitative and qualitative (free-text) data were collected to assess vaccine uptake, timing, and reasons for/against vaccination.
Key Findings: Vaccine Uptake and Timing
- By December 2021, 98% of respondents had received at least one COVID-19 vaccine dose.
- Pregnant/postpartum women received vaccines slightly later than others (median 3 vs. 0 days after eligibility), but 90% were vaccinated within 28 days.
- The Pfizer vaccine was most commonly used, followed by AstraZeneca and Moderna (mostly for boosters).
Motivations and Reasons for Vaccination
- Altruism, support for community immunity, and general pro-vaccine attitudes were leading motivations (>80%) for vaccination.
- Major concerns among vaccine-accepting women included getting COVID-19 and wanting to resume community activity.
- Planning pregnancy or fertility treatment was rarely a reason for accepting the vaccine.
Reasons for Hesitation or Refusal
- Very few women declined vaccination (1% by Sept 2022); main reasons were long-term and pregnancy-specific side effect concerns, perceived immunity, and insufficient information.
- Concerns about vaccine effects on pregnancy, breastfeeding, and advice from healthcare providers also contributed.
Qualitative Themes from Free-text Responses
- Strong motivation to vaccinate: Many sought protection for self, baby (via breastfeeding), and community.
- Adverse effects: Concerns about vaccine effects on menstruation, fertility, and potential links to pregnancy complications.
- Misinformation: Reports of conflicting, changing, or poorly communicated advice from authorities and healthcare workers.
- Complicated decision-making: Even among non-hesitant women, many found the process stressful and confusing, especially when information was lacking or unclear.
Implications and Recommendations
- High vaccine uptake occurred despite concerns and unclear/inconsistent guidance, especially for pregnant women.
- Altruistic and community-centered motivations superseded personal risk/benefit assessments.
- Clearer, consistent, and well-communicated information is needed, especially for high-risk groups and healthcare professionals.
Key Terms & Definitions
- WRA (Women of Reproductive Age) — Typically, women aged 18–50, including those pregnant, postpartum, or planning pregnancy.
- Vaccine Hesitancy — Reluctance or refusal to vaccinate despite availability.
- Altruism — The selfless concern for the well-being of others, motivating public health actions.
Action Items / Next Steps
- Review communication strategies to address vaccine misinformation and concerns for pregnant/postpartum women.
- Ensure healthcare providers receive consistent, evidence-based guidelines for advising WRA.
- Consider further research into vaccine communication and health literacy for reproductive outcomes.