Pregnant women’s perceptions and acceptance of vaccinations during the Covid-19 pandemic: a qualitative study.

Research question How do pregnant women perceive and feel about vaccinations as a result of the Covid-19 pandemic? Background Pregnant women are at increased risk of complications from some illnesses, as a result of physiological and immunological changes during pregnancy. Uptake of vaccinations amongst pregnant women is lower than desired. Little is known about how pregnant women feel about vaccinations during pregnancy- particularly the Covid-19 vaccination, and whether Covid-19 has influenced perceptions of vulnerability to other illnesses during pregnancy. Aim To examine pregnant women's perceptions about Covid-19 vaccinations and other routine vaccinations during pregnancy and to explore how their views on vaccination have been affected by the Covid-19 pandemic. Objectives 1. Explore perceptions of pregnant women requiring a Covid-19 booster or first/second vaccination during pregnancy about being invited to have/having the Covid-19 booster or first/second vaccination. 2. Explore the perception of pregnant women who require flu or pertussis vaccination during pregnancy about being invited to have/having the flu or pertussis vaccination. 3. Identify barriers and facilitators to uptake of vaccinations during pregnancy. 4. Explore midwives experiences of broaching and discussing vaccination with pregnant women and their perceived role in pregnant women s vaccination decisions. 5. Synthesise and disseminate findings to pregnant women, healthcare professionals and policymakers (including summary of findings sheets, dissemination event and e-learning modules). Methods Semi-structured interviews will be conducted with pregnant women and midwives in Coventry and Warwickshire. Pregnant women at any stage of pregnancy, who have and have not had the Covid-19 vaccination and with a variety of demographics will be recruited via midwives from community and antenatal hospital clinics. Midwives at two participating hospitals will be invited to take part, and information will be shared with midwife teams using posters, social media and weekly emails. Interested pregnant women and midwives will be given study information and asked to contact the research team. Interviews will be conducted remotely, and analysed using thematic analysis. Timelines for delivery This is a 12 month project. Months 1-4 will focus on recruitment and data collection, 2-10 will focus on data collection and data analysis, and 11-12 on dissemination. Anticipated Impact and Dissemination Summary sheets for healthcare professionals will be available via dedicated study webpages on University of Warwick website, and via RCM webpages, iLearn e-modules and networks. Summary sheets for policy makers will be available to download via webpages on University of Warwick website, and will be shared to professional bodies using established contacts within the research team. Summary sheets will be shared with pregnant women and members of the public via social media and relevant charities. This research will provide health professionals with improved understanding of pregnant women s vaccination decisions, and how Covid-19 has affected perceptions. This will help tailor Covid-19 vaccination and routine vaccination communication and interventions for pregnant women most likely to decline vaccination, and resources for midwives on communicating with women about vaccination. Findings will have potential impact on NHS England and Joint Committee on Vaccination and Immunisation (JCVI) policies as vaccination programmes continue to develop.