Is gravidity associated with COVID-19 vaccination among pregnant women in Jamaica?

TL;DR

This study found that pregnant women in Jamaica who have had multiple pregnancies are less likely to get vaccinated against COVID-19 compared to first-time pregnant women.

Contribution

The study is the first to examine the association between gravidity and vaccination in pregnant women in Jamaica.

Findings

Multigravidas had lower vaccination rates (46%) compared to primigravidas (75%) after adjusting for factors like age and education.

Multigravidas also reported lower vaccine confidence than primigravidas.

Government mistrust and race-based mistrust were similar between the two groups.

Abstract

In 2021, Jamaica’s maternal mortality ratio doubled as a result of COVID-19-related deaths. Yet, COVID-19 vaccination among pregnant Jamaican women remained low. In the United States, COVID-19 vaccination is lower among pregnant women who have had multiple pregnancies (multigravidas) versus women who were pregnant for the first time (primigravidas). We examined whether this pattern exists in Jamaica.

A cross-sectional survey of a convenience sample of 79 pregnant Jamaican women recruited from a teaching hospital (May–July 2022) was used to assess self-reported COVID-19 vaccination and medical mistrust beliefs—operationalized as low vaccine confidence, government mistrust, and race-based mistrust—by gravidity. We used modified Poisson regression to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for vaccination by gravidity, adjusting for age, education, and comorbidities.

Thirty-nine (49%) of the participants were multigravidas. Socioeconomic status was similar between multigravidas and primigravidas. COVID-19 vaccination was lower in multigravidas (46%) than primigravidas (75%) after adjusting for age, education, and comorbidities (aPR = 0.67, 95% CI = 0.46–0.99; p = 0.044). Vaccine confidence was lower in multigravidas (p = 0.044). Government mistrust and race-based mistrust did not differ between the two groups.

In Jamaica, multigravidas may have lower COVID-19 vaccine uptake and lower vaccine confidence compared with primigravidas. Understanding the distinct needs of pregnant subpopulations is essential for crafting effective maternal vaccination campaigns.