Early COVID-19 Vaccine Hesitancy Characteristics in Mothers Following Bariatric Surgery

Background: Obesity has played a central role in heightened coronavirus disease 2019 (COVID-19) risk and vaccine response. COVID-19 vaccine intention among those with a history of severe obesity, specifically those who have undergone bariatric surgery, has not been described. This study aims to examine early COVID-19 vaccine intention among mothers with a history of severe obesity who underwent bariatric surgery.

Methods: Sixty-four mothers (M_age = 39.3 years) who underwent bariatric surgery (M_{time since surgery} = 19.6 months) completed surveys online (November 2020-February 2021). Information obtained included their COVID-19 vaccine intention (vaccine ready, undecided, vaccine opposed). Analyses examined group differences in demographics, body mass index (BMI = kg/m²), knowledge of obesity-related COVID-19 risk, flu vaccination history, general beliefs about vaccine safety/effectiveness, and factors increasing confidence/motivation to obtain a COVID-19 vaccine.

Results: Thirty-six (56.3%) mothers had severe obesity (≥ Class II [BMI = ≥ 35 kg/m²]). The majority were vaccine hesitant (undecided [n = 28; 43.8%]; vaccine opposed [n = 15; 23.4%]). Compared to the vaccine-ready group, vaccine-hesitant groups were younger (p < .05). For the vaccine opposed, recent flu vaccination rates (p = .012) and general belief that vaccines are safe (p = .028) were lower than expected. Among hesitant participants, no reported side effects and the health of self and others were endorsed as top factors increasing vaccine confidence and motivation respectively.

Conclusions: While preliminary, the prominence of early vaccine hesitancy in this sample of mothers who have undergone bariatric surgery, with most persisting with severe obesity, indicates a subgroup at high risk. Factors to address through targeted messaging and intervention were identified.