Factors Influencing Vaccine-Hesitancy in First-Time Expectant Mothers: A Qualitative Study

Objective. To identify and better understand factors of vaccine-hesitancy in first-time expectant mothers, pertaining to childhood vaccines and compliance with the Advisory Committee of Immunization Practices (ACIP) schedule. Methods. Semi-structured interviews were conducted in the fall of 2018 and spring of 2019 with fifty vaccine-hesitant first-time expectant mothers living in the United States. The Parents Attitude About Childhood Vaccines-modified (PACV-m) survey identified vaccine-hesitancy. The interview question path was developed using the Theory of Planned Behavior and select constructs from the Health Belief Model, feedback from pilot study, and related literature. Interviews were transcribed and analyzed for themes. Conclusion. Most factors of vaccine-hesitancy are driven by a fear of injury to their child. Feeling informed was a factor that built confidence, but there were obstacles to getting reliable and comprehensive vaccine-information. Healthcare providers have an important role by providing vaccine-information during pregnancy, listening without judgment, and engaging in vaccine-related conversations. Most intended to use an alternative or delayed schedule but did not have a definite plan yet. There is parallel between reasons to not accept COVID-19 vaccine and childhood vaccine refusal. Recommendations are made to provide education and training to prenatal healthcare providers and to understand the social norms around the mothers’ decision to vaccinate