Demographic Variance in COVID‐19 Vaccine Hesitancy Among Reproductive‐Aged Females During the First Year of the Vaccine Rollout

ABSTRACT Objective Initial COVID‐19 vaccine trials excluded pregnant individuals, making eventual vaccine recommendations nongeneralizable. After noninferiority was established, the CDC, WHO, and ACOG supported vaccination of this group. However, only 31% of pregnant people accepted vaccination. This study aims to assess COVID‐19 vaccine hesitancy in a diverse cohort of reproductive‐aged females. Methods We used a validated WHO vaccine hesitancy survey tool, modified to address the COVID‐19 vaccine specifically. From August to November 2021, people capable of pregnancy aged 18–50 years were recruited from inpatient and outpatient OB/GYN services at a large, urban, academic centre in the Midwestern United States. The responses were collected anonymously and analysed using Kruskal–Wallis H and Mann–Whitney U tests. Results Fifty‐one of sixty participants partially or fully completed the survey. Black individuals were more vaccine‐hesitant in general than Hispanic and White individuals ( H [2] = 11.179, p < 0.01), and they were more hesitant toward the COVID‐19 vaccine specifically ( H [2] = 9.396, p < 0.01). Pregnant people were less confident that the COVID‐19 vaccine was safe overall ( H [2] = 11.473, p < 0.005) compared to those recently pregnant or not pregnant. Individuals not using contraception reported being significantly less confident in the safety of the COVID‐19 vaccine ( U = 96.500, p < 0.05). Individuals who declined the flu vaccine were more likely to be COVID‐19 vaccine‐hesitant ( U = 79.500, p < 0.001). Participants' age and occupation were not associated with vaccine hesitancy. Conclusion Vaccine hesitancy particularly among some demographic groups highlights the need to study the underlying factors contributing to a lack of confidence in the safety of the COVID‐19 vaccine. Synopsis Our validated survey‐based study found that Black participants capable of pregnancy were the most vaccine‐hesitant, highlighting a missed opportunity to care for these individuals.