Publication date: Feb 01, 2025

There is a wide variety of vaccination programs during pregnancy implemented in different European Union (EU) countries. The recent coronavirus disease 2019 (COVID-19) pandemic emphasized the need for efficient interventions to increase vaccine confidence during pregnancy since pregnant women were less likely to accept COVID-19 vaccination compared with nonpregnant women. This survey investigated the influence of the COVID-19 pandemic on vaccine confidence during pregnancy in 11 European countries. An online survey with questions on maternal vaccine confidence was distributed in 10 EU countries between March 29 and April 6, 2022. Via convenience sampling, 25 eligible participants per country were recruited. Subsequently, the survey was distributed in Flanders (Belgium) between October 14 and 26, 2022, delivering 480 eligible respondents. All participants were either pregnant or gave birth in the last 2 years. Across all countries, vaccine confidence during pregnancy was found to be lower than vaccine confidence in general. Safety concerns were indicated as the most important reason to refuse vaccination during pregnancy. Participants with higher education and who were above 30 years old showed more confidence toward vaccination during pregnancy. A total of 15% of the participants indicated that the COVID-19 pandemic negatively impacted their confidence toward vaccines. Vaccine confidence during pregnancy varies widely across the EU. However, across all surveyed countries, vaccine confidence during pregnancy is lower than vaccine confidence in general, and safety concerns appear to be the main driver of this. The COVID-19 pandemic negatively impacted the view on vaccination in a significant proportion of participants, indicating that vaccine implementation in a next pandemic should be tackled differently.

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