Racial/Ethnic Disparities in Maternal Vaccine Knowledge, Attitudes, and Intentions

• Published in: Public health reports (1974) 2021-11, Vol.136 (6), p.699-709
• Main Authors: Dudley, Matthew Z., Limaye, Rupali J., Salmon, Daniel A., Omer, Saad B., O’Leary, Sean T., Ellingson, Mallory K., Spina, Christine I., Brewer, Sarah E., Bednarczyk, Robert A., Malik, Fauzia, Frew, Paula M., Chamberlain, Allison T.
• Format: Article
• Language: English
• Subjects: Acceptance; Adult; Attitudes; Black people; Black white differences; Black women; Colorado; Decision making; Diphtheria; Ethnic and Racial Minorities - psychology; Ethnic and Racial Minorities - statistics & numerical data; Ethnic groups; Ethnicity; Female; Georgia; Health care; Health care industry; Health Knowledge, Attitudes, Practice; Health risks; Health services; Humans; Immunization; Infants; Influenza; Knowledge; Maternal and infant welfare; Minority & ethnic groups; Mothers; Mothers - psychology; Mothers - statistics & numerical data; Norms; Pertussis; Pregnancy; Prenatal care; Public health; Race; Racial differences; Risk perception; Safety; Social norms; Surveys and Questionnaires; Tetanus; Trust; Vaccination - adverse effects; Vaccination - methods; Vaccination - standards; Vaccines; White people; Women; Womens health
• ISSN: 0033-3549; 1468-2877
• DOI: 10.1177/0033354920974660

Objectives Although disparities in maternal vaccine acceptance among racial/ethnic groups are well documented, the reasons for these disparities are unclear. The objective of this study was to describe differences in pregnant women’s knowledge, attitudes, beliefs, intentions, and trust regarding maternal and infant vaccines by race/ethnicity. Methods We collected survey data from 1862 pregnant women from diverse prenatal care practices in Georgia and Colorado from June 2017 through July 2018. We performed multiple logistic regressions to determine differences in intentions, knowledge, attitudes, beliefs, and trust by race/ethnicity and calculated odds ratios (ORs) and 95% CIs. Results Compared with White women, Black and Hispanic women were less confident in vaccine safety and efficacy and less likely to perceive risk of acquiring vaccine-preventable diseases, report provaccine social norms, indicate having enough vaccine knowledge, and trust vaccine information from health care providers and public health authorities. Black women were the least confident in the safety of the maternal influenza vaccine (OR = 0.37; 95% CI, 0.27-0.49); maternal tetanus, diphtheria, and acellular pertussis vaccine (OR = 0.37; 95% CI, 0.27-0.52); and infant vaccines overall (OR = 0.40; 95% CI, 0.28-0.58), and were least likely to intend to receive both maternal vaccines (OR = 0.35; 95% CI, 0.27-0.47) or all infant vaccines on time (OR = 0.45; 95% CI, 0.34-0.61) as compared with White women. Conclusions Understanding differences in behavioral constructs integral to vaccine decision making among women of different races/ethnicities can lead to tailored interventions to improve vaccine acceptance.