Racial/Ethnic Disparities in Maternal Vaccine Knowledge, Attitudes, and Intentions

Public Health Rep. 2021 Nov-Dec;136(6):699-709. doi: 10.1177/0033354920974660. Epub 2021 Jan 28.


Objectives: Although disparities in maternal vaccine acceptance among racial/ethnic groups are well documented, the reasons for these disparities are unclear. The objective of this study was to describe differences in pregnant women's knowledge, attitudes, beliefs, intentions, and trust regarding maternal and infant vaccines by race/ethnicity.

Methods: We collected survey data from 1862 pregnant women from diverse prenatal care practices in Georgia and Colorado from June 2017 through July 2018. We performed multiple logistic regressions to determine differences in intentions, knowledge, attitudes, beliefs, and trust by race/ethnicity and calculated odds ratios (ORs) and 95% CIs.

Results: Compared with White women, Black and Hispanic women were less confident in vaccine safety and efficacy and less likely to perceive risk of acquiring vaccine-preventable diseases, report provaccine social norms, indicate having enough vaccine knowledge, and trust vaccine information from health care providers and public health authorities. Black women were the least confident in the safety of the maternal influenza vaccine (OR = 0.37; 95% CI, 0.27-0.49); maternal tetanus, diphtheria, and acellular pertussis vaccine (OR = 0.37; 95% CI, 0.27-0.52); and infant vaccines overall (OR = 0.40; 95% CI, 0.28-0.58), and were least likely to intend to receive both maternal vaccines (OR = 0.35; 95% CI, 0.27-0.47) or all infant vaccines on time (OR = 0.45; 95% CI, 0.34-0.61) as compared with White women.

Conclusions: Understanding differences in behavioral constructs integral to vaccine decision making among women of different races/ethnicities can lead to tailored interventions to improve vaccine acceptance.

Keywords: attitudes; ethnicity; pregnancy; race; vaccine(s).

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Colorado
  • Ethnic and Racial Minorities / psychology*
  • Ethnic and Racial Minorities / statistics & numerical data
  • Female
  • Georgia
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Mothers / psychology*
  • Mothers / statistics & numerical data
  • Surveys and Questionnaires
  • Vaccination / adverse effects
  • Vaccination / methods*
  • Vaccination / standards