Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter April 28, 2021

COVID-19 vaccine hesitancy in perinatal women: a cross sectional survey

Suruchi Mohan, Shuja Reagu, Stephen Lindow and Majid Alabdulla



To explore attitudes to COVID-19 vaccination among perinatal women.


A nationwide online, cross-sectional survey was conducted in Qatar from 15th October 2020 to 15th November 2020 with voluntary participation open to all adult residents. Of the respondents, the population group for this study comprised the 341 pregnant and breastfeeding participants. The survey utilized a composite questionnaire incorporating a validated instrument to measure vaccine attitudes. The responses were recorded and analysed with statistical analysis being performed with SPSS software. Outcome measures included intentions towards vaccination and potential factors influencing vaccine hesitancy (contextual factors, vaccine specific concerns and group/individual influences).


Perinatal women exhibited a vaccine hesitancy rate of 25% towards COVID-19 immunisation. The main concerns of the group were of infection risks and main factor determining vaccine hesitancy was of vaccine specific safety concerns. Previous vaccine “acceptors” showed vaccine hesitancy to COVID-19 immunisation. A third of the group cited non availability of the vaccine as a concern.


COVID-19 vaccine trials amongst pregnant and lactating women have lagged behind those for general populations and this has compounded concerns around safety in this special group. Perinatal women constitute a vulnerable group and play an important role in vaccination of wider family members. This study highlights the need for trials and data for COVID-19 vaccine in this group to be able to achieve appreciable numbers needed for herd immunity and ultimately control of the pandemic.

Corresponding author: Suruchi Mohan, Department of Obstetrics and Gynaecology, Sidra Medicine, PO Box 26999, Doha, Qatar; and Weill Cornell Medicine, Doha, Qatar, E-mail:
Suruchi Mohan and Shuja Reagu share first authorship.

  1. Research funding: None declared.

  2. Author contributions: SR, MA and SM conceptualized the study idea and designed the study tool. SR collected data. SM wrote the manuscript draft. SL carried out interpretation and statistical analysis. All authors reviewed and edited the manuscript. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The project was granted ethical approval by the Medical Research Council of the Hamad Medical Corporation (MRC approval-01-20-930).


1. National, Geographic. Mapping the global spread of the Coronavirus. Available from: [Accessed 14 Jan 2021].Search in Google Scholar

2. World Health Organisation. Impact of COVID-19 on people’s livelihoods, their health and our food systems. Available from: [Accessed 14 Jan 2021].Search in Google Scholar

3. World Bank. The global economic outlook during the Covid-19 pandemic: a changed world. Available from: [Accessed 14 Jan 2021].Search in Google Scholar

4. Maria, N, Zaid, A, Catrin, S, Ahmed, K, Ahmed, AJ, Christos, I, et al.. The socio-economic implications of the coronavirus pandemic (COVID-19): a review. Int J Surg 2020;78:185–93.10.1016/j.ijsu.2020.04.018Search in Google Scholar

5. New York, Times. Coronavirus vaccine tracker. Available from: [Accessed 14 Jan 2021].Search in Google Scholar

6. World Health Organisation. Vaccines and immunisation. Available from: [Accessed 14 Jan 2021].Search in Google Scholar

7. Dubé, E, Laberge, C, Guay, M, Bramadat, P, Roy, R, Bettinger, JA. Vaccine hesitancy: an overview. Hum Vaccines Immunother 2013;9:1763–73. in Google Scholar

8. World Health Organisation. Vaccine hesitancy: a growing challenge for immunization programmes. Available from: [Accessed 14 Jan 2021].Search in Google Scholar

9. World Health Organisation. Ten threats to global health in 2019. Available from: [Accessed 14 Jan 2021].Search in Google Scholar

10. World Health Organization. Summary WHO SAGE conclusions and recommendations on vaccine hesitancy. Available from: [Accessed 14 Jan 2021].Search in Google Scholar

11. New York, Times. Mistrust of a Coronavirus vaccine could imperil widesprad immunity. Available from: [Accessed 14 Jan 2021].Search in Google Scholar

12. Alabdulla, M, Reagu, S, Al Khal, M, Elzain, M, Jones, R. Covid-19 Vaccine hesitancy and attitudes in Qatar; a nationally representative cross-sectional survey of a migrant majority population. Influenza Other Respir Viruses 2021;15:361–70. in Google Scholar

13. Fisher, KA, Bloomstone, SJ, Walder, J, Crawford, S, Fouayzi, H, Mazor, KM. Attitudes toward a potential SARS-CoV-2 vaccine: a survey of US adults. Ann Intern Med 2020;173:964–73. in Google Scholar

14. Sherman, SM, Smith, LE, Sim, J, Amlôt, R, Cutts, M, Dasch, H, et al.. COVID-19 vaccination intention in the UK: results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey. Hum Vaccines Immunother 2020:1–10. in Google Scholar

15. Dashraath, P, Wong, JL, Lim, MX, Lim, LM, Li, S, Biswas, A, et al.. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol 2020;222:521–31. in Google Scholar

16. Turan, O, Hakim, A, Dashraath, P, Jeslyn, WJ, Wright, A, Abdul‐Kadir, R. Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS‐CoV‐2 infection among hospitalized pregnant women: a systematic review. Int J Gynecol Obstet 2020;151:7–16. in Google Scholar

17. Craig, AM, Hughes, BL, Swamy, GK. COVID-19 vaccines in pregnancy. Am J Obstet Gynecol MFM 2020:100295. in Google Scholar

18. The American College of Obstetricians and Gynecologists. Docket no. CDC-2020-0100; advisory committee on immunization practices; notice of meeting; establishment of public docket; request for comments; 2020. Available from:∼/- /media/ba82df62bd0149f0a1019a6662038fc5.ashx.Search in Google Scholar

19. Society for Maternal-Fetal Medicine. Society for maternal-fetal medicine (SMFM) statement: SARS-CoV-2 vaccination in pregnancy; 2020. Available from: 1-20_(final).pdf.Search in Google Scholar

20. Heath, PT, Le Doare, K, Khalil, A. Inclusion of pregnant women in COVID-19 vaccine development. Lancet Infect Dis 2020;20:1007–8. in Google Scholar

21. Chamberlain, AT, Seib, K, Ault, KA, Orenstein, WA, Frew, PM, Malik, F, et al.. Factors associated with intention to receive influenza and tetanus, diphtheria, and acellular pertussis (Tdap) vaccines during pregnancy: a focus on vaccine hesitancy and perceptions of disease severity and vaccine safety. PLoS Curr 2015:7. in Google Scholar PubMed PubMed Central

22. Wilson, RJ, Paterson, P, Jarrett, C, Larson, HJ. Understanding factors influencing vaccination acceptance during pregnancy globally: a literature review. Vaccine 2015;33:6420–9. in Google Scholar

23. Royal College of Obstetricians and Gynaecologists. Covid-19 vaccine information sheet. Available from: [Accessed 2 Feb 2021].Search in Google Scholar

24. Martin, LR, Petrie, KJ. Understanding the dimensions of anti-vaccination attitudes: the vaccination attitudes examination (VAX) scale. Ann Behav Med 2017;51:652–60.c. in Google Scholar

25. Sousa, VD, Rojjanasrirat, W. Translation, adaptation and validation of instruments or scales for use in cross‐cultural health care research: a clear and user‐friendly guideline. J Eval Clin Pract 2011;17:268–74. in Google Scholar

26. Market IpSOS Research. Global attitudes to Covid-19 vaccine. Available from: in Google Scholar

27. Lazarus, JV, Ratzan, S, Palayew, A, Billari, FC, Binagwaho, A, Kimball, S, et al.. COVID-SCORE: a global survey to assess public perceptions of government responses to COVID-19 (COVID-SCORE-10). PloS One 2020;15:e0240011. in Google Scholar

28. Peretti-Watel, P, Seror, V, Cortaredona, S, Launay, O, Raude, J, Verger, P, et al.. A future vaccination campaign against COVID-19 at risk of vaccine hesitancy and politicisation. Lancet Infect Dis 2020;20:769–70. in Google Scholar

29. Taylor, S, Landry, CA, Paluszek, MM, Groenewoud, R, Rachor, GS, Asmundson, GJ. A proactive approach for managing COVID-19: the importance of understanding the motivational roots of vaccination hesitancy for SARS-CoV2. Front Psychol 2020;11:2890. in Google Scholar

30. De Bel-Air, F. Demography, migration, and labour market in Qatar. Migration Policy Centre, GLMM, Explanatory note, 8/2014. Retrieved from Cadmus, European University Institute Research Repository, at:. 2014. Available from: in Google Scholar

31. Kouzy, R, Abi Jaoude, J, Kraitem, A, El Alam, MB, Karam, B, Adib, E, et al.. Coronavirus goes viral: quantifying the COVID-19 misinformation epidemic on Twitter. Cureus 2020;12. in Google Scholar

32. Puri, N, Coomes, EA, Haghbayan, H, Gunaratne, K. Social media and vaccine hesitancy: new updates for the era of COVID-19 and globalized infectious diseases. Hum Vaccines Immunother 2020:1–8.10.1080/21645515.2020.1780846Search in Google Scholar

33. Pfizer pharmaceuticals. Pfizer and Biontech commence global clinical trial to evaluate Covid-19 vaccine in pregnant women. Available from: in Google Scholar

34. Anderson, RM, Vegvari, C, Truscott, J, Collyer, BS. Challenges in creating herd immunity to SARS-CoV-2 infection by mass vaccination. Lancet 2020;396:1614–6. in Google Scholar

Supplementary Material

The online version of this article offers supplementary material (

Received: 2021-02-06
Accepted: 2021-04-14
Published Online: 2021-04-28
Published in Print: 2021-07-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Scroll Up Arrow