Drivers and deterrents of COVID-19 vaccination among a diverse, pregnant population with and without HIV

Vaccination for SARS-CoV-2 during pregnancy is safe, effective, and beneficial, yet uptake among pregnant people living with HIV (PLHIV) and pregnant HIV-seronegative individuals remains suboptimal, particularly among minority individuals. The objective was to understand perspectives of racial and ethnic minority pregnant PLHIV and pregnant HIV-seronegative individuals regarding receiving the COVID-19 vaccine. In this qualitative investigation, a semi-structured interview guide was used to conduct in-depth interviews with pregnant ( >28 weeks of gestation) or postpartum (< 6 months) PLHIV and HIV-seronegative individuals. Purposive sampling was conducted to recruit individuals with a range of vaccination experiences and to include diversity in pregnant vs. postpartum status, race/ethnicity, and insurance. Interviews addressed perspectives on receiving the COVID-19 vaccine during pregnancy, including drivers and deterrents of vaccination. Interviews were analyzed using the constant comparative method. Of 33 individuals (15 PLHIV, 18 HIV-seronegative), the majority identified as non-Hispanic Black (70%) or Hispanic (27%) and 73% had received the COVID-19 vaccine. Analysis identified drivers and deterrents to vaccine uptake that were both pregnancy-specific and non-specific. Drivers included consistency in antenatal care providers, desire to protect the fetus or self, and trust in medical care providers (Table, Fig). Additional drivers for PLHIV included perceptions of increased vulnerability to COVID-19. Several themes were identified as both drivers and deterrents of vaccination (Fig), including media portrayals of COVID-19 during pregnancy and personal experiences of COVID-19. In contrast, deterrents included inconsistency in medical providers and fear of side effects. Our analysis suggests that drivers of COVID-19 vaccination for pregnant people from minority backgrounds are similar regardless of HIV status. Public health efforts to improve vaccine uptake in pregnancy should include PLHIV and partner with clinicians for consistent and thorough vaccine messaging.View Large Image Figure ViewerDownload Hi-res image Download (PPT)