"Did I make the right choice for my baby?" Relationality in vaccination decision-making while pregnant

In Canada, public health recommends vaccination against the flu, whooping cough, and COVID-19 in every pregnancy. Public health also recommends consideration of RSV vaccination in pregnancy. Pregnant people often feel solely responsible to make decisions about these vaccinations. Yet, all health decisions are shaped by relationships with partners, family, friends, healthcare providers, social media, and the wider community. This study explores how social relationships shape decisions about recommended vaccinations in pregnancy. Study data include qualitative interviews with pregnant people and healthcare providers. Interviews were completed during the COVID-19 pandemic in Canada. Most participants completed two interviews. The first interview explored experiences with making decisions about vaccination. The second interview was about vaccination information. Data analysis was qualitative. Thirty-nine individuals participated in this study. Of those, thirty-one were pregnant. Twelve were healthcare providers who discuss vaccination in pregnancy with patients. Participants were located across Canada. The interviews show how social relationships shape individual decision-making about vaccination in pregnancy. For instance, one pregnant participant asked, "Did I make the right choice for my baby?" Then, she said she intended to get a second COVID-19 vaccine to help end the pandemic. Pregnant participants talked about how family, friends, and healthcare providers influenced their individual decisions. Healthcare providers also showed how gender inequities and social relations affect patient decision-making. Study results show vaccination decisions are informed by a many social relationships and inequities. Findings suggest more attention is needed to the diverse social contexts to better support pregnant people's decision-making.