Factors associated with COVID-19 vaccination among breastfeeding and pregnant people: Application of the health belief model.

Publication date: Jun 22, 2026

This study explored the factors associated with COVID-19 vaccination among pregnant and breastfeeding people by applying the Health Belief Model. We conducted an online cross-sectional survey in British Columbia, Canada between October and December 2021. Pregnant and breastfeeding people were recruited through social media, online maternal and child health groups, and maternal and child community-based support organizations. We assessed self-reported COVID-19 vaccination status as well as health beliefs and perceptions toward COVID-19 vaccination. Bivariable and multivariable logistic regression were used to identify the predictors of vaccination uptake. Among 874 participants (361 pregnant and 513 breastfeeding), 72. 5% reported receiving at least one dose of the COVID-19 vaccine. Breastfeeding participants were almost twice as likely to be vaccinated than pregnant participants (adjusted odds ratio [aOR] = 1. 95; 95% Confidence interval [CI] = 1. 29-2. 93). Higher education levels and healthcare provider recommendations were positively associated with COVID-19 vaccination. Vaccinated participants had higher levels of perceived severity of COVID-19 infection (aOR = 1. 93, 95% CI = 1. 07-3. 48) and perceived benefits of COVID-19 vaccines (aOR = 4. 82, 95% CI = 2. 80-8. 30). Participants with more perceived barriers were more likely to be unvaccinated (aOR = 0. 09, 95% CI = 0. 04-0. 17). The COVID-19 vaccination rates among pregnant and breastfeeding people were suboptimal, with vaccine uptake associated with modifiable factors related to individual health beliefs. This study highlighted the importance of positive healthcare provider recommendations in overcoming vaccine concerns.

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