J Korean Soc Matern Child Health.  2022 Oct;26(4):245-253. 10.21896/jksmch.2022.26.4.245.

Knowledge and Acceptability of the COVID-19 Vaccine Among Obstetricians and Gynecologists in Korea, and Factors Affecting Its Recommendation in the Pregnant Population

• Choi BY
• Yoon H
• Seong WJ
• Cho GJ
• Na S
• Jung YM
• Ko HS
• Park JS

• KMID: 2535915
• DOI: http://doi.org/10.21896/jksmch.2022.26.4.245

Abstract

Purpose
To analyze the overall knowledge and attitude of healthcare providers regarding coronavirus disease (COVID-19) vaccine recommendations for pregnant women and factors affecting these opinions in Korea.
Methods
We conducted a nationwide survey study of obstetricians and gynecologists registered in the Korean Society of Obstetrics and Gynecology. The knowledge, attitude, and factors affecting COVID-19 vaccination in pregnant women were investigated.
Results
Among 258 participants, 182 (70.5%) answered that they recommended COVID-19 vaccination for pregnant women, while 76 (29.5%) answered that they did not. The administrative district of the physician's healthcare center and knowledge regarding adverse reactions to the COVID-19 vaccine were factors affecting opinions on vaccine recommendation. Physicians working in metropolitan cities were 7.3 times more likely to recommend COVID-19 vaccination to pregnant women than those working in Seoul. Physicians aware of the COVID-19 vaccine safety profiles in pregnant women were 25.36 times more likely to recommend vaccines than those who were not. A significantly higher proportion of the recommended group provided vaccine information to pregnant women compared to the nonrecommended group and also recommended booster shot vaccination. Guidelines from academic societies (70.9%) and from government and public centers (64.8%) were important factors in the recommendation group, while additional study results (57.1%) were important factors in the nonrecommendation group. This information will be useful for future reference regarding vaccine recommendations.
Conclusion
Providing guidelines and recent data regarding COVID-19 vaccination in pregnant populations to healthcare providers will promote obstetricians and gynecologists to recommend vaccination to pregnant patients and will thereby contribute to achieving herd immunity in Korea.

Keyword

SARS-CoV-2 infection; COVID-19; Vaccination; Pregnant women

Figure

• 

  Fig. 1. Survey questions.

Reference

Blakeway H., Prasad S., Kalafat E., Heath PT., Ladhani SN., Le Doare K., et al. COVID-19 vaccination during pregnancy: coverage and safety. American Journal of Obstetrics and Gynecology. 2022. 226:236. e1– 236.e14.

Brauer E., Choi K., Chang J., Luo Y., Lewin B., Munoz-Plaza C, et al. Health care providers' trusted sources for information about COVID-19 vaccines: mixed methods study. JMIR Infodemiology. 2021. 1:e33330.

Chervenak FA., McCullough LB., Bornstein E., Johnson L., Katz A., McLeod-Sordjan R, et al. Professionally responsible coronavirus disease 2019 vaccination counseling of obstetrical and gynecologic patients. Am J Obstet Gynecol. 2021. 224:470–8.

Citu IM., Citu C., Gorun F., Sas I., Bratosin F., Motoc A, et al. The risk of spontaneous abortion does not increase following first trimester mRNA COVID-19 vaccination. J Clin Med. 2022. 11:1698.

Daskalakis G., Pergialiotis V., Antsaklis P., Theodora M., Papageorgiou D., Rodolakis A. Healthcare workers' attitudes about vaccination of pregnant women and those wishing to become pregnant. J Perinat Med. 2021. 50:363–6.

Favre G., Maisonneuve E., Pomar L., Winterfeld U., Daire C., Martinez de Tejada B, et al. COVID-19 mRNA vaccine in pregnancy: results of the Swiss COVI-PREG registry, an observational prospective cohort study. Lancet Reg Health Eur. 2022. 18:100410.

Goldshtein I., Nevo D., Steinberg DM., Rotem RS., Gorfine M., Chodick G, et al. Association between BNT162b2 vaccination and incidence of SARS-CoV-2 infection in pregnant women. JAMA. 2021. 326:728–35.

Head KJ., Kasting ML., Sturm LA., Hartsock JA., Zimet GD. A national survey assessing SARS-CoV-2 vaccination intentions: implications for future public health communication efforts. Sci Commun. 2020. 42:698–723.

Januszek SM., Faryniak-Zuzak A., Barnaś E., Łoziński T., Góra T., Siwiec N, et al. The approach of pregnant women to vaccination based on a COVID-19 systematic review. Medicina (Kaunas). 2021. 57:977.

Kharbanda EO., Haapala J., DeSilva M., Vazquez-Benitez G., Vesco KK., Naleway AL, et al. Spontaneous abortion following COVID-19 vaccination during pregnancy. JAMA. 2021. 326:1629–31.

Kucirka LM., Norton A., Sheffield JS. Severity of COVID-19 in pregnancy: a review of current evidence. Am J Reprod Immunol. 2020. 84:e13332.

Lee JH., Song JY., Yi KW., Kim JJ., Hwang KR., Shin JH, et al. Contra-ception in the COVID-19 pandemic: recommendations from the Korean society of contraception and reproductive health. Obstet Gynecol Sci. 2022. 65:125–32.

Lee SJ., Li L., Hwang JY. After 20 years of low fertility, where are the obstetrician-gynecologists? Obstet Gynecol Sci. 2021. 64:407–18.

Lin C., Mullen J., Smith D., Kotarba M., Kaplan SJ., Tu P. Healthcare providers' vaccine perceptions, hesitancy, and recommendation to patients: a systematic review. Vaccines (Basel). 2021. 9:713.

Magnus MC., Gjessing HK., Eide HN., Wilcox AJ., Fell DB., Håberg SE. Covid-19 vaccination during pregnancy and first-trimester miscar-riage. N Engl J Med. 2021. 385:2008–10.

Magnus MC., Wilcox AJ., Morken NH., Weinberg CR., Håberg SE. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. BMJ. 2019. 364:l869.

Martins I., Louwen F., Ayres-de-Campos D., Mahmood T. EBCOG position statement on COVID-19 vaccination for pregnant and breastfeeding women. Eur J Obstet Gynecol Reprod Biol. 2021. 262:256–8.

Mathieu E., Ritchie H., Rodés-Guirao L., Appel C., Giattino C., Hasell J, et al. Coronavirus pandemic (COVID-19) [Internet]. OurWorldInd Data.org;;2020. [cited 2022 Oct 15]; Available from:. https://ourworldindata.org/coronavirus.

Mukherjee S., Velez Edwards DR., Baird DD., Savitz DA., Hartmann KE. Risk of miscarriage among black women and white women in a U.S. Prospective Cohort Study. Am J Epidemiol. 2013. 177:1271–8.

Nguyen KH., Yankey D., Lu PJ., Kriss JL., Brewer NT., Razzaghi H, et al. Report of health care provider recommendation for COVID-19 vaccination among adults, by recipient COVID-19 vaccination status and attitudes - United States, April-September 2021. MMWR Morb Mortal Wkly Rep. 2021. 70:1723–30.

Nir O., Schwartz A., Toussia-Cohen S., Leibovitch L., Strauss T., Asraf K, et al. Maternal-neonatal transfer of SARS-CoV-2 immuno-globulin G antibodies among parturient women treated with BNT162b2 messenger RNA vaccine during pregnancy. Am J Obstet Gynecol MFM. 2022. 4:100492.

Shimabukuro TT., Kim SY., Myers TR., Moro PL., Oduyebo T., Pana-giotakopoulos L, et al. Preliminary findings of mRNA Covid-19 vaccine safety in pregnant persons. N Engl J Med. 2021. 384:2273–82.

Skirrow H., Barnett S., Bell S., Riaposova L., Mounier-Jack S., Kampmann B, et al. Women's views on accepting COVID-19 vaccination during and after pregnancy, and for their babies: a multi-methods study in the UK. BMC Pregnancy Childbirth. 2022. 22:33.

Stafford IA., Parchem JG., Sibai BM. The coronavirus disease 2019 vaccine in pregnancy: risks, benefits, and recommendations. Am J Obstet Gynecol. 2021. 224:484–95.

Wainstock T., Yoles I., Sergienko R., Sheiner E. Prenatal maternal COVID-19 vaccination and pregnancy outcomes. Vaccine. 2021. 39:6037–40.

Zambrano LD., Ellington S., Strid P., Galang RR., Oduyebo T., Tong VT, et al. Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020. 69:1641–7.

Zauche LH., Wallace B., Smoots AN., Olson CK., Oduyebo T., Kim SY, et al. Receipt of mRNA Covid-19 vaccines and risk of spontaneous abortion. N Engl J Med. 2021. 385:1533–5.