Intention to receive COVID-19 vaccine during pregnancy: A systematic review and meta-analysis.

Objective: This meta-analysis aimed to assess the level of intent to receive COVID-19 vaccination and demographical factors influencing vaccine uptake among pregnant individuals. Study design: PubMed, Scopus and archive/pre-print servers were searched up to 22nd May, 2021. Cross sectional surveys reporting the percentage of the pregnant individuals intending to get a COVID-19 vaccine were considered eligible for meta-analysis. This review was registered with PROSPERO (CRD42021254484). The primary outcome was to estimate the prevalence of COVID-19 vaccination intent among pregnant population. The secondary outcome was to evaluate the factors influencing intention for vaccination. Results: Twelve studies sourcing data of 16,926 individuals who identified as pregnant were eligible. The estimated intention for receipt of COVID-19 vaccine among women who were pregnant was 47% (95% CI: 38% - 57%), with the lowest prevalence in Africa 19% (95% CI: 17% - 21%) and the highest in Oceania 48.0% (95% CI: 44.0% - 51.0%). Uptake of other vaccines (influenza and/or TdaP) during pregnancy was associated with higher rate of intent to receive the COVID-19 vaccine (OR = 3.03; 95% CI: 1.37–6.73; P 0.006). Conclusion: The intent to receive COVID-19 vaccine is relatively low among women who are pregnant and substantially varies based on country of residence. In our meta-analysis, intent of women who were pregnant to receive the COVID-19 vaccine was significantly associated history of receiving of influenza or TdaP vaccine during pregnancy. Given that in every country only a minority of gravidae have received the COVID-19 vaccine, despite known risks of maternal morbidity and mortality with no evidence of risks of vaccination, highlights the importance of revised approaches at shared decision making and focused public health messaging by national and international advisories.