Knowledge and attitudes of pregnant women about COVID-19 vaccination

Tekbaş, Serap

doi:10.1590/1518-8345.7331.4521

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Original Article • Rev. Latino-Am. Enfermagem 33 • 2025 • https://doi.org/10.1590/1518-8345.7331.4521 linkcopy

Knowledge and attitudes of pregnant women about COVID-19 vaccination

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective: to assess the knowledge and attitudes of pregnant women towards COVID-19 vaccination and the factors that affect them.

Method: this is a cross-sectional and analytical study with 407 pregnant women. The COVID-19 Vaccine Knowledge and Attitude Scale was used to assess the knowledge and attitudes of pregnant women towards COVID-19 vaccination. Mann-Whitney U and Kruskal-Wallis H tests were used for statistical analysis.

Results: it was found that 63.88% of the sample had a negative opinion about being vaccinated against COVID-19 during pregnancy. Seventy-five percent of the pregnant women believed that the vaccine would harm their fetus. The mean subscale scores of the severity (p = 0.001) and benefit (p = 0.001) of the vaccine were significantly higher in pregnant women with a higher level of education and in the first trimester (p = 0.001). It was found that pregnant women who stated that they had sufficient information about COVID-19 had significantly higher severity (p = 0.001) and benefit (p = 0.031) subscale mean scores and had a more positive attitude against COVID-19 vaccination during pregnancy.

Conclusion: most pregnant women had negative attitudes due to concerns that the COVID-19 vaccine would harm the fetus. Healthcare professionals should provide education about the importance of vaccination during pregnancy for maternal and infant health during pregnancy follow-up.

Descriptors
Vaccine; COVID-19; Women; Pregnancy; Knowledge; Attitude

Highlights

(1) The study evaluated vaccine acceptance and COVID-19 vaccine attitude during pregnancy. (2) Pregnant women participated in the study. (3) Negative attitudes towards vaccines during pregnancy was detected. (4) The study results can be a guide to inform health institutions about vaccine acceptance.

Socio-demographic and obstetric characteristics	n *	% ^†
Age group ( mean 27.61±4.73 years)
24 years and younger	85	20.88
25-28 years	172	42.26
29 years and older	150	36.86
Educational background
Primary School	27	6.63
Secondary School	55	13.51
High School	75	18.43
University	215	52.83
Postgraduate	35	8.60
Income level
Income less than the expense	68	16.71
Income equal to the expense	307	75.43
Income higher than the expense	32	7.86
Employment status
Yes	292	71.74
No	115	28.26
Type of employment
Full-time	229	56.27
Part-time	178	43.73
Type of family
Nuclear family	376	92.38
Extended family	31	7.62
Time married
0-3 years	216	53.07
4-10 years	136	33.42
11 years or more	55	13.51
Gestational age
1 ^st trimester	111	27.27
2 ^nd trimester	163	40.05
3 ^rd trimester	133	32.68
Pregnancy
First	254	62.41
Second	118	28.99
Third or more	35	8.60
Number of living children
None	257	63.14
One	115	28.26
Two or more	35	8.60

Vaccination status and COVID-19-related characteristics	n *	% ^†
Being vaccinated against tetanus
Yes	43	10.57
No	364	89.43
Being vaccinated against influenza
No	407	100.00
Paying attention to hand hygiene
Yes	407	100.00
Paying attention to social distancing
Yes	407	100.00
Paying attention to using a facial mask
Yes	407	100.00
Having contracted COVID-19
Yes	78	19.16
No	329	80.84
Having contracted COVID-19 during pregnancy
Yes	52	12.78
No	355	87.22
Personal status regarding the COVID-19 vaccine
I received a COVID-19 vaccine before pregnancy	211	51.84
I received a COVID -19 vaccine both before and during pregnancy	32	7.86
I have not been vaccinated yet. I plan to be vaccinated during my pregnancy	41	10.07
I plan to get vaccinated after pregnancy	32	7.86
I plan to get vaccinated after my breastfeeding period	40	9.83
I do not plan to receive a COVID -19 vaccine	51	12.53
View on receiving a COVID-19 vaccine during pregnancy
Negative	260	63.88
Positive	147	36.12
Reason for a positive opinion (n=147)
I believe the vaccine protects me from COVID-19 during pregnancy	91	61.90
I believe the vaccine protects my infant from COVID -19 during pregnancy	56	38.10
Reason for a negative opinion (n=260)
I believe the vaccine would harm my infant	195	75.00
I believe the vaccine poses risk to my infant’s life	123	47.31
I believe the vaccine poses risk to my infant’s mental development	107	41.15
Obtained information about COVID-19 vaccine during pregnancy
Yes	339	83.29
No	68	16.71
Did you have sufficient knowledge about the COVID-19 vaccine
Yes	247	60.69
No	160	39.31
What information sources on COVID-19 did you have
Doctor	353	86.73
Social media	185	45.45
Specialists through TV or Internet	224	55.04
Nurse	118	28.99
Family and friends	63	15.48

Vaccination status and COVID-19-related characteristics	Severity			Barrier			Benefit
Vaccination status and COVID-19-related characteristics	x̄*	SD ^†	p ^‡	x̄*	SD ^†	p ^‡	x̄*	SD ^†	p ^‡
Having COVID-19 infection
Yes	16.00	4.20	0.062	22.36	3.84	0.886	12.44	3.83	0.019
No	18.01	4.66		22.92	5.53		11.93	3.83
Having COVID-19 during pregnancy
Yes	15.00	4.85	0.003	23.54	4.24	0.029	11.15	4.13	0.224
No	18.01	4.48		22.71	5.38		12.16	3.77
Personal status regarding COVID-19 vaccine
Being vaccinated before pregnancy	18.97	3.95	0.001	22.42	4.43	0.001	13.00	3.21	0.001
Planning to be vaccinated both before and during pregnancy	20.25	2.95		18.88	5.41		15.88	2.46
Planning to be vaccinated during pregnancy, since she has not yet been vaccinated	19.83	4.54		19.15	2.02		13.61	1.51
Planning to be vaccinated after pregnancy	17.50	1.97		22.00	3.93		12.50	1.97
Planning to be vaccinated after breastfeeding period	13.50	4.56		23.00	5.06		9.50	3.54
Never thought of receiving a COVID-19 vaccine	11.96	2.47		30.25	3.45		6.00	0.00
Opinion on receiving a COVID-19 vaccine during pregnancy
Negative	16.15	4.47	0.001	24.32	5.62	0.001	10.77	4.10	0.001
Positive	20.22	3.70		20.16	3.07		14.26	1.74
Obtained information about COVID-19 vaccine during pregnancy
Yes	17.87	4.93	0.018	22.65	4.94	0.500	12.14	3.81	0.443
No	16.38	2.36		23.62	6.59		11.50	3.92
Consider that has enough information about COVID-19 vaccine
Yes	18.36	4.77	0.001	22.17	5.30	0.031	12.30	4.05	0.031
No	16.48	4.18		23.81	5.03		11.61	3.42

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