Factors Associated with Inpatient COVID-19 Vaccine Uptake for Pregnant and Postpartum People

In order to promote vaccine access during the pandemic, hospitals in Boston offered the COVID-19 vaccines to eligible inpatients including pregnant and postpartum individuals. We sought to evaluate inpatient vaccine uptake for this peripartum population and to assess factors associated with vaccination status at time of antepartum or postpartum admission. We conducted a retrospective cohort study of patients admitted to the antepartum and postpartum services of two academic hospitals between April 2021 and July 2022. Patients were classified as “sufficiently vaccinated” (fully vaccinated or not yet due for an additional dose) or “eligible for vaccination” at the time of admission. We used chi-square, independent samples t-test, and Wilcoxon rank sum test to compare demographic and clinical characteristics. We described trends in inpatient vaccination over time. Among 886 antepartum and 13,115 postpartum patients, 341 (38.5%) and 6,559 (50%) were sufficiently vaccinated at the time of hospital admission, respectively. Factors associated with vaccination (Table) included receipt of Tdap and influenza vaccination during pregnancy. Younger age, Black race, Hispanic ethnicity, public insurance, tobacco use, and multiparity were associated with being unvaccinated at the time of hospitalization. Among those eligible for vaccination, only 30 (5.5%) antepartum and 72 (1.1%) postpartum patients received inpatient vaccination. The greatest number of patients in both groups were vaccinated in October, November, and December 2021 (Figure). The uptake of COVID-19 vaccination in the peripartum population was lower than that of non-pregnant individuals in the state and was especially low among patients who were younger, Hispanic, Black, and publicly insured. General vaccine acceptance during pregnancy was associated with COVID-19 vaccine uptake. Availability of inpatient vaccination alone was insufficient to significantly increase vaccine uptake in this hesitant population; however, inpatient antepartum vaccination did increase when pregnancy became a booster-eligible condition.View Large Image Figure ViewerDownload Hi-res image Download (PPT)