Attitudes and Communication Preferences for Vaccines among Pregnant Women Receiving Care at a Safety-net Hospital

Published:October 08, 2021DOI:



      We aimed to understand pregnant women's perceptions of vaccination during pregnancy and to assess their reaction to different vaccine messages.

      Study Design

      English-speaking pregnant women aged 18 years or older who received prenatal care at a safety-net hospital participated in qualitative interviews. Interview topics included attitudes toward vaccinations in general and toward influenza and tetanus–diphtheria–pertussis vaccination in pregnancy. Participants were also queried regarding sources of vaccine information, and were asked to provide feedback on specific messages regarding maternal vaccination.


      Twenty-eight pregnant women participated in interviews. Participant age ranged from 18 to 40 years old; 64% were insured through Medicaid. All participants had positive attitudes toward routine vaccinations and had received vaccinations for themselves and their children. Attitudes were less favorable for influenza vaccines than other vaccines. Participants reported receiving vaccine information from multiple sources. Stories about vaccine harms worried participants, even when they did not trust the sources of negative information. All stated that their health care providers were the most trusted source of information. Participants felt that the most important messages to encourage maternal vaccination were that maternal vaccination protects the baby after birth and maternal vaccination is safe for both mother and baby. Participants were not motivated to vaccinate by messages about the severity of maternal disease.


      Maternal vaccinations are important to protect pregnant women and infants from influenza and pertussis. Focusing on messages related to vaccine safety and protection of the infant are motivating to mothers, especially when delivered by trusted health care providers.
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      Taylor L. Fuss, MD, MPH, Boston University School of Medicine. Dr. Fuss has an interest in pediatrics and vaccinations.


      Jean L. Devera, BS, Boston University School of Medicine. Mr. Devera has an interest in pediatrics and vaccinations.


      Natalie Pierre-Joseph, MD, MPH, Boston University School of Medicine. Dr. Pierre-Joseph is a pediatrician with a longstanding interest in vaccinations and health equity.


      Rebecca B. Perkins, MD, MSc, Boston University School of Medicine. Dr. Perkins is an obstetrician-gynecologist with a longstanding interest in vaccinations and health equity.