Vaccination Beliefs and Attitudes of Lactating People During the SARS-CoV-2 Pandemic

Background: Pregnant and recently pregnant people have lower vaccination rates against SARS-CoV-2 than the general population, despite increased risk of adverse outcomes from infection. Little is known about vaccine hesitancy in this population.

Research aim: To characterize SARS-CoV-2 and other vaccine attitudes of lactating people who accepted the SARS-CoV-2 vaccine, describing their vaccine experiences to further contextualize their beliefs.

Methods: A prospective cross-sectional online survey design was used. We administered the survey to 100 lactating people in Pennsylvania from April to August 2021, upon enrollment into a longitudinal study investigating SARS-CoV-2 vaccine antibodies in human milk. This survey assessed SARS-CoV-2 vaccine attitudes, vaccine counseling from providers, and vaccine decision making. Associations between vaccination timing and beliefs were analyzed by Pearson chi-square.

Results: Of 100 respondents, all received ≥ 1 SARS-CoV-2 vaccine before or shortly after enrollment, with 44% (n = 44) vaccinated in pregnancy and 56% (n = 56) while lactating. Participants reported vaccination counseling by obstetric (n = 48; 70%) and pediatric (n = 25; 36%) providers. Thirty-two percent (n = 32) received no advice on SARS-CoV-2 vaccination from healthcare providers, while 69% (n = 69) were counseled that vaccination was safe and beneficial.While 6% (n = 6) and 5% (n = 5) reported concerns about the safety of maternal vaccines for lactating people or their infants, respectively, 12% (n = 12) and 9% (n = 9) expressed concerns about the safety of maternal SARS-CoV-2 vaccination in particular.

Conclusions: Despite high uptake of SARS-CoV-2 vaccine among participants, safety concerns persisted, with many reporting a lack of direct counseling from providers. Future research should investigate how variability in provider counseling affects SARS-CoV-2 vaccine uptake in perinatal populations.