Perinatal & Pediatric
Comparing COVID-19 vaccine confidence, recommendations, and practices among healthcare providers caring for pregnant persons, Fall DocStyles Survey, United States, 2021–2023 Grayson Waits* Grayson Waits Rebecca Hall Jessica Meeker Cristin McArdle Ayeesha Sayyad Romeo Galang Sascha Ellington Regina Simeone Carrie Shapiro-Mendoza
Vaccination during pregnancy can provide important protections for pregnant women and their infants; however, maternal COVID-19 vaccination in the U.S. remains low. Pregnant women are more likely to be vaccinated if their provider recommends it.
We used DocStyles, a web-based panel survey of US physicians, to compare three attitudes and behaviors from 2021–2023: confidence in counseling pregnant patients on COVID-19 vaccination (2022–2023), recommending the COVID-19 vaccine to pregnant patients (2022–2023), and offering the COVID-19 vaccine to pregnant patients (2021–2023). Adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) estimated associations between year and these three outcomes; aPRs were adjusted for provider age, gender, and number of years practicing.
Of the 3,198 respondents (78% primary care physicians [PCPs] and 22% obstetrician-gynecologists [OB-GYNs]), neither provider type experienced a significant change in confidence in counseling pregnant patients about the COVID-19 vaccine from 2022 to 2023. However, PCPs and OB-GYNs recommended COVID-19 vaccination to their pregnant patients less often in 2023 than in 2022 (aPR: 0.95 [CI: 0.91, 0.99] and aPR: 0.95 [CI: 0.90, 1.00]). In both years, a higher proportion of OB-GYNs reported confidence in counseling and recommending the vaccine compared to PCPs. Overall, PCPs and OB-GYNs confident in counseling pregnant patients on COVID-19 vaccination were more likely to recommend the vaccine than those who were not confident, regardless of year (aPR: 2.0 [1.72, 2.32] and aPR: 2.6 [1.35, 5.25]). PCPs offered the COVID-19 vaccine less often in 2023 than in 2021 (aPR: 0.84 [0.76, 0.92]). PCPs whose practice offered the vaccine were more likely to recommend it than those who did not offer (aPR: 1.33 [1.27, 1.40]).
It is important to understand patterns in physician attitudes and practices regarding maternal COVID-19 vaccination to inform focused messaging and resources to physicians in the US.