Date of Award

1-1-2024

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Olivia N. Kachingwe

Abstract

Compared to the general population, pregnant people and newborns are at a higher risk of contracting infectious diseases and experiencing worse adverse outcomes. Vaccines delivered during pregnancy, known as prenatal vaccines, represent a critical yet underused form of preventive care for these populations in the United States. Increasing successful prenatal vaccination uptake requires a focus on both access and acceptance, which pregnant people may experience differently than non-pregnant people due to their unique physiological and social state. Given the evolution of vaccine hesitancy following the COVID-19 pandemic, coupled with the recent expansion of the U.S. prenatal immunization schedule, this study seeks to explore elements shaping pregnant people’s experiences of access and acceptance with prenatal vaccines during the last respiratory virus season (September 1, 2023-January 31, 2024). Using reflexive thematic analysis, the current study analyzed Reddit discussion threads (59 primary posts and 2535 comments/replies) to produce themes and subthemes focused on pregnant people’s access and acceptance of CDC-recommended prenatal vaccines (flu, Tdap, COVID-19, and RSV). Four overarching themes were constructed: pressures of the biological time crunch, divergent interpretations of vaccine science, expanded ideals of pregnancy and parenthood, and external endorsements in a polarized climate. Results showed that pregnant people were intensively concerned with not only their own vaccination, but also the vaccination of their family members. Findings found that pregnant people’s experiences of access were shaped by factors concerning the introduction of the new RSV vaccine, the time sensitivity of female reproductive biology, and the utility of relationships with different healthcare providers, whereas experiences of acceptance were shaped by individual understandings of science and sexual health, the social experience of pregnancy and vaccination, and the stigmatization of vaccine uncertainty. Study findings carry actionable implications for advancing future public health research, policy, and practice: these insights are crucial for enhancing prenatal vaccine access and acceptance in the United States, particularly given anticipated introductions of new prenatal vaccines and changing attitudes in the COVID-19 context.

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This is an Open Access Thesis.

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