Most pregnant women globally say they would get the COVID-19 vaccine, but American moms-to-be are hesitant

• Most pregnant women and mothers said they would get a safe and free COVID-19 vaccine last fall.
• Fewer women in the US, Russia, and Australia said they would get the vaccine.
• Pregnant people may worry about harming their fetuses even if the vaccine has proven safe so far.

Pregnant people are eligible to get their COVID-19 vaccines in the US and are prioritized in certain states, but whether or not they get vaccinated has largely been left up to individual choice.

A survey of pregnant women and mothers of young children across the globe recently found that a majority would be willing to get a safe and free COVID-19 vaccine, although acceptance was lower in the US, Russia, and Australia.

The questionnaire went out to nearly 18,000 women in 16 countries last fall, back when such a vaccine was hypothetical, from researchers at the Harvard T.H. Chan School of Public Health. Their results were published today in the European Journal of Epidemiology.

Overall, 52% of pregnant respondents and 73% of non-pregnant mothers surveyed said they would get the COVID-19 vaccine themselves were it safe to use, free, and 90% effective at preventing infection. Of all women surveyed, 69% said they would vaccinate their children.

The Pfizer and Moderna vaccines have been safely administered to more than 20,000 pregnant women. Both shots had efficacy rates exceeding 90% in clinical trials, so the vaccines available in the US closely resemble the hypothetical vaccine described in the survey.

Vaccine acceptance was lowest in the US, Russia, and Australia

Some countries had higher vaccine acceptance than others in the fall survey, the researchers found.

In the US and Russia, less than 45% of pregnant respondents and less than 56% non-pregnant respondents said they would get a COVID-19 vaccine themselves. The researchers suspected this trend could be related to prevalent COVID-19 denial in the two countries.

Australia and New Zealand also had relatively low vaccine acceptance rates, but the researchers thought that was more likely connected to dwindling COVID-19 case counts - the pandemic simply posed less of a threat to Australians when the survey was conducted there.

Vaccine acceptance was highest among pregnant women and mothers of young children in India, the Philippines, Brazil, and Mexico, according to survey results.

Providers should listen to pregnant women's concerns before explaining the vaccine-supporting science

In general, those who felt reluctant to get a COVID-19 vaccine cited lack of confidence in the process, or fears that the vaccine development was rushed or politically motivated, as reasons for their hesitancy.

Pregnant people had additional concerns about how the vaccine might affect their developing fetus, the survey found.

Based on the way the COVID-19 vaccines work - they do not contain live viruses - the shots are unlikely to pose any harm to developing babies, experts have told Insider.

As for speed of the vaccine development process, Dr. Anthony Fauci, the US' leading infectious disease expert, has repeatedly emphasized that the technology used for COVID-19 vaccines has been years in the making. "The process of the speed did not compromise, at all, safety, nor did it compromise scientific integrity," Fauci said in a White House briefing in November. "It was a reflection of the extraordinary scientific advances in these types of vaccines which allowed us to do things in months that actually took years before. So I really want to settle that concern that people have about that."

Emily Adhikari, medical director of perinatal infectious diseases at Parkland Hospital in Texas, told Insider that physicians should listen to and validate these concerns while providing a clear message about vaccine safety.

"Pregnant women face additional challenges in weighing the benefits of protection against COVID-19 for themselves with the fear and guilt associated with making a decision that they perceive could harm the fetus," Adhikari, who was not affiliated with the survey, wrote in an email to Insider.

"These fears don't have to be based on science - and evidence is mounting that they aren't - to be real to a mother," she added.