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Hesitancy Among Pregnant Women

3. Vaccination during pregnancy seemingly contradicts existing public health advice for pregnant women who are told to closely monitor what they take in and who are eliminating routine parts of their diet for the health and safety of their babies.

4. Subpar prenatal care for women of color and the shift to telehealth caused by the pandemic have contributed to less vaccination among this group.

Misinformation is running rampant among pregnant women, especially around the vaccine causing infertility

Exclusion of pregnant women from initial vaccine trials and testing has allowed misinformation to spread widely among this group.

DANIELA

1 - That misconception has flourished on social media despite tech giants such as Facebook and YouTube cracking down on pandemic misinformation. Many of the smaller apps and websites that are aimed toward first-time parents don’t have the resources at their disposal to properly police their platforms. (“What to Expect When You’re Expecting). New Age and other holistic influencers have been offering complex and unproven treatments that feel empowering because anyone at home can easily follow along and believe that they are performing best medical practices and precautions. Routes such as those can be incredibly appealing to some, especially those who have typically felt dismissed or ignored in medical settings.

2 - Given the lack of data early on, trusted sources like the CDC and the American College of Obstetricians and Gynecologists hesitated on recommending the shots for pregnant and lactating people rather than advising patients to consult with their doctors. Lack of research among pregnant women in clinical trials has been a long-held institutional problem because the Food and Drug Administration (FDA) has listed pregnant women on their list of “vulnerable populations” outlined in the Common Rule – the country’s ethical code for medical research in humans.

3 - Public health officials have long urged pregnant women to closely monitor and change their behaviors, things like eating habits, exercise, seemingly routine activities are all put under a microscope and warned against having potential risks for their pregnancy. “You’re not supposed to eat turkey lunch meat but you’re recommending that I get a vaccine that hasn’t been studied yet.” “You’ve got to understand that, at baseline, people who are pregnant are terrified. There’s so much social messaging around pregnancy that makes pregnant people feel like everything around them could be a threat.” Given the high-risk and high-alert nature of being pregnant in our society, any hint of concern or harm tends to spread and create conditions ripe for misinformation. That cultural norm has resulted in higher vaccine hesitancy among pregnant people than their nonpregnant peers.

4 - Access to prenatal care has been transformed by the pandemic, making visits less frequent and less likely to be in person. For women of color, particularly Black women who historically receive substandard maternal health and prenatal care, it is harder for providers to gain trust and offer recommendations. Less office visits also creates less opportunities for vaccination, and the historical mistrust of the medical industry for these communities heightens vaccine hesitancy.

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Hesitancy in General

3. History of medical distrust among communities of color.

4. Conspiracy theories and the spread of mis and disinformation.

5. Desire to choose freely.

Fear of unknown side effects and concerns over the speed of vaccine development.

Mistrust of elected officials and pharmaceutical companies

MICHAEL

1 - The rapid development of the vaccine gave rise to fears that certain precautionary steps in the vaccine creation process had been skipped over to begin vaccinating the general public sooner rather than later. When pressed about the facts involved in the scientific process behind creating the vaccine, many did not know exactly what went on behind the scenes to have such a rapid turnaround compared to previous mass vaccination efforts. Frank Luntz’s focus group held with 19 conservatives who opposed the COVID-19 vaccine shines some light on how we can address this issue. Luntz found that hard data that laid out the facts of how the vaccine was able to be developed so quickly, vaccine side effects, data around the usage of the vaccine by the medical community and data around the lack of negative outcomes led to higher rates of trust and agreement to be vaccinated.

2 - elected officials are believed to be using the pandemic to push for personal agendas such as the acceptance of universal health care or attempting to demonize and discredit the other side due to a herd mentality. In the same vein, these individuals also believe that pharmaceutical companies have additional economic motives behind the public facing motif of goodwill for the public. Again bridging into conspiracy theories, such beliefs include a multiyear plan to continuously push for booster shots for increased economic gain or a lack of research done on the vaccines so that companies could begin making profit as soon as possible. The best way to counteract this theme is to provide individuals with the facts behind the vaccine process and remind them that regardless of political party preference, taking the vaccine is ultimately their choice.

3 - Most notably found in Black communities, memories of the infamous Tuskegee experiment have widened the gap of mistrust that communities of color have with the medical community. That grows on top of decades worth of research that proved that people of color have received subpar care in medical facilities in addition to not being taken seriously with their medical concerns when asking medical professionals for help. However, this is not always the case. While communities of color do have a general distrust of the overall medical community, their opinions and respect toward medical professionals they know personally actually is quite higher.

4 - fueled by mis/dis info – While being the overarching theme of multiple debates surrounding vaccine hesitancy, the concerns coming out of these conspiracy theories are incredibly real for those who believe them. That is why when addressing such concerns as the government is putting microchip trackers in the vaccine, it is important to address the concerns as a serious issue and treat them with the same level of professionalism as one would treat more widely accepted concerns.

5 - Another major point of contention in Frank Luntz’s focus group is between the vaccine hesitant and anyone else who attempts to “take away their choice” of whether or not to get vaccinated. As the country splits further apart into an us vs. them mentality on a multitude of topics, vaccine hesitant individuals feel as though they are being told what to do. That backs them further into their corner, preferring to believe that if they get the vaccine, regardless of their reasoning, they will be acting as a “sheep” to politicians and corporate pharmaceutical companies.

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Identifying Your Audiences

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Your Audiences

Hispanic pregnant women who mistrust elected officials and pharmaceutical companies and have a deep concern for the health and safety of their baby.

Among this group, there is a subgroup of those who have been more heavily influenced by mis/disinformation vs. those who simply do not want to be told what is best and do not feel confident it is safe enough.

Black pregnant women who have a historical distrust of the medical community, deep concern for the health and safety of their baby.

Among this group, there is a sub-groups of those who have been more heavily influenced by mis/disinformation vs. those who simply do not want to be told what is best and do not feel confident it is safe enough.

DANIELA

We have more fleshed out audience profiles that will include their values, barriers, motivations, tips for messaging, and best ways to communicate them that we are developing and will share before we segment out the core messaging into audience-specific messaging.

Ad Council

Audience Briefs, Messaging to Avoid

While we are developing our own audience profiles that will layer on what we know about each community with what we know about pregnant people’s vaccine hesitancy, the Ad Council’s audience briefs for Black and Hispanic communities offered the following guidance on messaging to avoid. Notably, this guidance was true across both communities:

Negativity, fear and reminders of how difficult the pandemic has been.
Positioning getting a vaccine as “the right thing to do.”
Overpromising that getting a vaccine will “flip the switch” and end the pandemic immediately.
Using “back to normal” when things will never be normal for so many people – focus on “back to life” or “back to the moments we miss” as most compelling.

Audience Briefs, Messaging Principles

The Ad Council’s key messaging principles also mostly carried across both communities:

Lead with the “new news” to break through, such as variants or increasing local urgency.
Lead with empathy and respect that people have real questions or concerns.
Position vaccines as a way to help people protect themselves and their loved ones.
The ideal tone is empathetic, urgent, authentic and respectful if people have questions or concerns.
Respect people’s independence and urge them to make an informed decision.
Gain trust by being honest and transparent where appropriate.
Pair the rational information with the emotional side of the moments we all miss.
Welcome questions and point people to the latest clear information.
Emphasize that an option is now available that’s fully FDA approved.

But there were some critical differences that reflected the nuance between each community.

Specifically, for Black communities, the Ad Council named the following:

Community is critical, with an emphasis on local neighborhoods, churches and schools.
Be careful of singling out Black communities and/or depicting responsibility for vaccination to be resting on their shoulders (any creative should include diverse audiences).

Whereas for Hispanic communities, the Ad Councilemphasized the importance of:

Using visuals of more intimate festive moments shared with family and friends, with Hispanic representation and multiple generations included.
The audience appreciating the notion of “real people” being involved in communications related to the vaccine and concepts that “put everyone at the same level.”
Continuing to focus on vetted information, to overcome the prevalence of myths and misconceptions around vaccines and COVID-19.

Messaging Tips

The Ad Council’s messaging tips had some notable differences between communities.

For Black communities, it recommends:

Addressing frequently asked questions, for example, about pre-existing conditions (e.g., hypertension, diabetes, obesity, lupus) and the vaccines. Information needs to be clear, honest and presented in plain language. Facts about safety are important.
Sharing that researchers made sure that the clinical trials included adults of diverse backgrounds, races, ethnicities and geographic areas. They collaborated with faith leaders, community organizations and health clinics to reach volunteers from many different walks of life across the United States.
Acknowledging that low confidence in vaccines among Black Americans is partly due to concerns about safety and side effects and distrust of government. Also, worries are in part linked to historical unethical practices in medical research (e.g., Tuskegee experiments) as well as systemic health care inequities, especially laid bare by the pandemic.

For Hispanic communities, it recommends:

Leveraging peer-to-peer communication. Compared to the other groups, Hispanics are more receptive to messages from voices within their inner circle such as neighbors, family and influencers they follow on social media.
Using doctors as trusted messengers. Research shows that the overwhelming majority of Hispanics who have low confidence are more likely to get vaccinated if they get a strong recommendation from their doctor

Whereas the below recommendations held across communities:

Present vaccines as one important option in our toolbox to fighting the pandemic, e.g., “Vaccines are a key” or “By getting vaccinated, we help protect ourselves ….” Other language: “Everyone should continue to use all available tools to help stop the pandemic ….”
Name that some people who receive the COVID-19 vaccines may experience some discomfort and mild side effects. That is normal and means the vaccines are working to create an immune response.
Highlight the importance of keeping your family and those most vulnerable safe.

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The Role of the Messenger

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Your Messengers

Practitioners of color who are NOT vaccine hesitant

Practitioners of color who are vaccine-hesitant

White Practitioners who are NOT vaccine-hesitant

White Practitioners who are vaccine-hesitant

KRISTINE - Can you pull out the messenger profiles in slide here somehow? Maybe just the buckets you laid out - 4 types and then keep the rest for notes for yourself in this notes section here?

As you know health care providers are the most trusted source of information for pregnant women. In that, your messengers are going to be a really critical piece of this puzzle. We segmented your audience into these four main groups and like your audiences there will be different strategic approaches, messages, and resources for each.

If helpful, this was in focus group findings:

Trusted Messengers

Pregnant women most trust the recommendations and information their doctors (PCP or OB-GYN) provide.

They must be a trusted and respected medical provider – they cannot dismiss the women and their thoughts.
If the women do not have a trusted provider, they might go to Google or their friends and family (what they think and feel).
Faith based leaders: If they were promoting the vaccine, it would be meaningful.
Doulas: Focus on empowering their participant and encouraging them to do their own research.

Most of the practitioners either aren’t allowed or aren’t empowered to ask patients whether they’ve received the COVID-19 vaccine (but they do ask about other vaccinations, like the flu).
Some of the practitioners themselves expressed hesitation to get the vaccine and reference pseudoscience, like alternative medicine, for keeping individuals healthy and free from illnesses.

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Overall Findings & Recommendations

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Affirm feelings of concern over side effects and safety while laying out scientific evidence in simple language.

Across the research, it is clear that one of the biggest barriers to getting the vaccine for pregnant women is concerns over safety. There is concern that the vaccine was developed too quickly; that the side effects will be worse for them on top of the many symptoms of pregnancy; and that it could risk harm to the baby, even causing birth defects.

Of course, some of this is influenced by general disinformation and hesitancy around the vaccine for some, but for pregnant women the health and safety of their babies is of utmost concern and must be taken seriously. We recommend acknowledging those concerns and the reality of the potential side effects while providing the facts about the safety of the vaccine in simple and easy-to-understand language.

Language like, “it’s normal to be worried about your baby” is helpful here. It is also important to consider that pregnancy comes with its own host of symptoms that are often painful, so the risk of doing something that could cause any additional symptoms is a valid concern. Rather than dismiss or diminish the potential side effects of the vaccine, we recommend being honest and straightforward about what pregnant women may experience while reinforcing the vaccine’s safety.

While we don’t recommend proactively offering the details on the exclusion of pregnant women from initial clinic trials for the vaccine, if a patient asks, it is important to be clear about the facts, the historical reasons for exclusion and – most importantly – the real-world data and research since that have proven not only safety but benefits for pregnant people and their babies.

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2. Frame the choice to be vaccinated as autonomy; embrace encouragement over shame.

The need to emphasize autonomy was clear throughout our research. This audience does not want to be told what to do, they know what is best for them and their baby, and they need to be encouraged to make the choice that is best for them without shame or judgment.

We recommend avoiding language like, “it’s the right thing to do” and shifting to language we saw exemplified in the Ad Council’s campaign, “It’s up to you.”

Given the divisiveness on this issue in our country and widespread mis- and disinformation around the vaccine broadly, heightened by the overwhelming concern for their child, this audience needs its concerns to be taken seriously. Regardless of how conspiratorial pregnant people’s concerns may be, it is important to remember their primary concern is the health and safety of their child and they will do nothing to risk that.

Neel Shah, an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and chief medical officer of Maven Clinic, a telehealth company for women’s health, captured this well, “You’ve got to understand that, at baseline, people who are pregnant are terrified. There’s so much social messaging around pregnancy that makes pregnant people feel like everything around them could be a threat.”

Given the high risk and high alert nature of being pregnant in our society, any hint of concern or harm tends to spread and create conditions ripe for misinformation. This cultural norm has resulted in higher vaccine hesitancy among pregnant people than their nonpregnant peers. However, it is important to note the COVID-19 vaccines aren’t the first to be recommended during pregnancy – the Centers for Disease Control and Prevention (CDC) also recommends whooping cough and flu vaccines.

Shame is not a motivating factor for this audience. Politically, as we saw in Frank Luntz’s focus group for the vaccine hesitant, feeling robbed of their choice is more likely to make them feel like “sheep” to politicians and corporate pharmaceutical companies. There can be no othering or hyperbole when describing the vaccine hesitant as a whole. Remember pregnant people are not a monolith, and they are also not simply a part of the vaccine hesitant; they are concerned about their baby first and foremost. Sticking to facts and away from politics is the best approach.

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3. Emphasize benefits of vaccines, including protection for infants after birth, without fear mongering.

A lot of the messaging we saw is simply reassuring people that the vaccine is safe for them and their baby. While that is, of course, important, the most impactful messages are the ones that go a step further to say the vaccine is beneficial to women and their babies.

The vaccine allows for a healthy pregnancy and delivery and actually improves maternal and infant outcomes. We recommend emphasizing those benefits in your messaging. Research has shown that COVID-19 can increase the risk of a variety of pregnancy complications, including preterm birth and stillbirth, but we do not recommend leading with those risks because they elicit fear.

That said, the opposite framing of emphasizing the dangers and risk of COVID-19 to pregnant women, proved to be ineffective. Many public health campaigns currently emphasize how sick a pregnant person could get if they do not get a particular vaccine, but research confirms messaging regarding the severity of maternal disease was not a motivating factor. Fearmongering and condescension of all forms both in one-on-one conversations and in public-facing messages do not work; in fact, it only makes hesitancy worse.

Historically, vaccinations have a higher uptake rate when they protect the infant after birth. Thankfully, new research from the CDC indicates that the COVID-19 vaccines also protect infants after birth.

This new study found that vaccination during pregnancy protects infants from being hospitalized for COVID-19 in the first six months of life. This is a powerful message because new mothers are deeply concerned about the health and safety of infants. Given the state of the pandemic, it is impossible to control exposure to COVID-19, so knowing that their newborn infant, who is too young to receive the vaccine themselves, could be exposed but would likely not have to be hospitalized if infected is a worthy message to lift for this audience. We recommend messaging like, “Maternal vaccination is a really important way to help protect your young infant after birth.”

We recommend applying the following data points in your messaging:

The new study is the first real-world, epidemiological evidence that maternal vaccination can protect infants from COVID-19, likely because they are born carrying their mother’s antibodies.
Overall, maternal vaccination was 61% effective at preventing infant hospitalization, the researchers found.
Vaccination later in pregnancy – after the first 20 weeks – appeared to provide better protection for infants than earlier vaccination, the study suggests.

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4. Address head on differing reasons for vaccine hesitancy between Hispanic and Black communities.

While there is significant research out there on the reasons for vaccine hesitancy in Hispanic and Black communities and vaccine hesitancy among pregnant women, there is not much we could find on vaccine hesitancy for Latina and Black pregnant women. However, from our findings of both communities, there is much we can infer. We can assume that the primary concerns regarding pregnancy and health and safety for one’s baby remain across communities.

In the one research study we had on pregnant people of color, findings showed that both unvaccinated and vaccinated participants were knowledgeable about the risks of COVID-19 infection in pregnancy and were taking prevention precautions. Perceived benefits of vaccination included having a healthy pregnancy and baby, reduced stress about COVID-19 infection and resuming social activities. All vaccinated participants reported having conversations with providers about vaccination, but the same provider engagement was not found among the unvaccinated. Concerns about the vaccines centered on bias in health care and vaccine safety.

Women of color, particularly Black women historically receive substandard maternal health and prenatal care. The shift to telehealth caused by the pandemic has transformed prenatal care, making visits less frequent and less likely to be in person. It is harder for providers to gain trust and offer recommendations. Less office visits also creates less opportunities for vaccination, and the historical mistrust of the medical industry for these communities heightens vaccine hesitancy.

Across Black and Hispanic communities broadly, there is research that demonstrates shared concerns over safety and side effects of the vaccine, driven by the speed in which it was developed and a desire for more information. However there are, of course, specific nuances that added to vaccine hesitancy for each. Hispanic communities demonstrated distrust in political and economic motives of the government and corporations; while Black communities shared that mistrust, they also had a distrust of the medical community rooted in the very real history of medical mistrust.

Given those nuances, messengers are critically important. For Hispanic communities messaging landed better when it came from their trusted inner circles – anyone from neighbors to family members and various community leaders. For Black communities, the same is true, while faith played a larger role as well as doctors who are well known and trusted.

Given the centuries of medical mistreatment and the Tuskegee experiment, for Black communities, it is important to include messaging on the development of the vaccine and that testing was inclusive of all races and identities and was proven to be safe and effective for members of their own community. To layer on top of this, the impact this medical mistreatment has had on Black maternal health care, we can assume these concerns are heightened for Black pregnant women. It is important for health care providers to be culturally competent with this audience and address head on the historical and current racist practices ongoing in the health care system.

Given the outsized risk of COVID-19 in these communities, related to existing health disparities and conditions and lack of access to culturally competent and inclusive health care, Black women are also at higher risk of severe complications and death due to COVID-19. That suggests that messaging encouraging the vaccine’s safety and benefits will be especially meaningful for them.

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5. Based on our research practitioners (especially when they have a close relationship to patients) are very trusted messengers. As with all messengers authenticity is key. If appropriate and possible, our reach found that the best indictor for vaccine uptake was a persistent, confident and encouraging recommendation of vaccinations.

Across our research, it is clear that doctors and medical professionals, when known, are trusted messengers among our primary audience of pregnant women of color. In a study of this group, the vaccinated participants stated that they had conversations about COVID-19 and the vaccines with their health care providers at prenatal visits.

In this group, they mentioned both initiating those conversations themselves as well as their health care providers initiating conversations. In situations where they were hesitant about getting the vaccine, they said that they decided to trust their health care provider’s suggestion to get vaccinated because they wanted to protect their baby’s development. Among the unvaccinated, several mentioned that their health care providers did not initiate conversations about vaccination, and others stated that their providers did not formally recommend the vaccines or they recommended waiting until they were in the third trimester, when the baby was better developed, to get vaccinated.

We noted that there was some vaccine hesitancy among the practitioners during the first focus group. We strongly recommend encouraging all Public Health Solutions (PHS) practitioners to consistently integrate the conversation on vaccination in all visits with pregnant moms in culturally sensitive ways that are encouraging and confident in the efficacy and safety of the vaccine and encourage getting the vaccine in the earliest stages of pregnancy possible. Despite their personal opinions or feelings, it should be named as part of their responsibilities to initiate these conversations, explain the safety and benefits, and move from simply saying it is safe to encouraging patients to get the vaccine.

If possible and relevant, it is important to know what measure the respective health centers associated with each practitioner is doing to address and improve quality of care for Black women in particular as a result of systemic health inequity. We recommend that formal training take place to improve quality of care across the board to ensure a deeper trust between patients and practitioners from the outset and to ensure cultural competency of practitioners when interacting with patients of all backgrounds.

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6. Humanize creative and visual assets and ensure they are inclusive of all races, include visuals that emphasize community, family, and socializing.

Throughout the research, we saw that visuals and creative assets that showed people, including pregnant people, were most effective. Also, given that doctors are trusted messengers, visuals that include doctors are also helpful and centering the community as trusted messengers is also important.

For pregnant women of color, the perceived benefits of vaccination included having a healthy pregnancy and baby, reduced stress about COVID-19 infection and resuming social activities. Graphics or visuals that show that return to socializing as well as healthy and safe babies are also helpful.

Given the distrust of the medical industry citing institutions are no longer as effective with these communities, citing individuals with their credentials is much more humanizing and effective. Rather than saying “the CDC says,” naming a specific doctor and their credentials is more effective.

A recent Texas Tribune article walked readers through the life-threatening journey of one pregnant mother and her husband as she struggled with the effects of COVID-19 during pregnancy while being unvaccinated and came back from the brink of death. Humanizing the pandemic is one of the most constructive methods of building support behind vaccination. Consider including direct quotes and images from women who were hesitant and now thankful to have received the vaccine, without fearmongering, in your creative assets.

THIS IS ALIGN WITH WHAT WE SAW IN OUR GRAPHICS SCAN –

Key Findings

While most of the current ads mention the vaccine’s safety, only a few show how it’s safe (by referencing data and trends). The ads that show how we know the vaccine is safe for pregnant women are especially effective.
Many of the graphics aren’t visually compelling and include either too little or too much text.
Notably, one of the pregnant women featured was cut off from the head, which can be a dehumanizing depiction for pregnant women.
The centering of a Black woman in one goes against the recommendations we heard that Black communities prefer not to be singled out when it comes to vaccine hesitancy.
There’s an opportunity to create materials that:

Are visually compelling, including updated/modern graphics and images of pregnant women.
Explain the benefit of getting the vaccine – both for the mother and the unborn child.
Explain how we know the vaccine is safe for pregnant women (through trials, etc.)
Feature trusted messengers, like doctors
Tell pregnant women exactly where and how to get the vaccine

We reviewed existing public service announcements that PHS assembled that included the below. For more context on the specific findings from each announcement, ad or graphic, please see Appendix B below.

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Core

Messages

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Core Message Framing

KRISTINE

The below messaging is organized in message boxes. Message boxes are intended to serve as core concepts -- the main point you want your audience to remember -- to keep in mind when communicating. They aren’t meant to be memorized word for word. Appropriately using these message boxes requires tailoring them to the specific members of each audience you speak to and for the mechanism you use to communicate to them. We will define that together through our audience and messenger profiles.

Message boxes help frame the top four points most relevant and compelling when speaking to your primary audiences.

These four points include:

Value: Your value message is where you reinforce a belief that you and your audience share. This should be something you easily agree on and will elicit affirmative nodding in response.
Barrier Breaker: To persuade an audience to take an action you’d like them to take, you need to identify what barriers currently stand in the way of them not taking that action. The message you craft needs to overcome this barrier without repeating it. The audience-specific message sets we develop after we finalize the core messaging will be especially important here as each audience has different barriers.
Ask: Your ask is where you simply state a specific action you hope for this specific audience member to take.
Vision: Your vision is a space to explain to your audience why they should take this action, what vision of the world will be possible – a vision they share – if they take the action you ask them to take.

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VALUE

It is normal to be worried about your baby, pregnancy already comes with so many unknowns and can be a confusing and scary time. As a mom you have to make a lot of everyday decisions, from what you eat to what you do, and getting a vaccine is certainly worth assessing before you decide.
I can confidently tell you that the vaccine is safe for both of you. The science is clear and straightforward. You want to make good choices for your baby and I would not recommend anything that risked either of your health and safety.
During pregnancy, you are already experiencing such a wide range of symptoms that can be difficult to anticipate and manage. It’s important to know that the COVID-19 vaccine may have some mild short term side effects that usually go away within a few days, including.

Your health and safety, and that of your baby, is our highest priority.

DANIELA

You’ll notice these all connect back to the findings and recommendations.

This is hard one - you have to acknowledge without repeating the barrier/creating more fear.

Of course the health and safety of your baby is your highest priority, as your [insert title - health care provider, etc] it is mine too.
It is normal to be worried about your baby, pregnancy already comes with so many unknowns and can be a confusing and scary time. As a mom you have to make a lot of everyday decisions, from what you eat to what you do, and getting a vaccine is certainly worth assessing before you decide.

It’s important to remember that getting vaccinated while pregnant has been a longstanding practice. When you’re pregnant, doctors recommend that you get whooping cough and flu vaccines to protect you and your child. . COVID-19 vaccines are just another vaccine that the CDC identified as beneficial.

I can confidently tell you that the vaccine is safe for both of you. The science is clear and straightforward. You want to make good choices for your baby and I would not recommend anything that risked either of your health and safety.

INSERT DATA.

During pregnancy, you are already experiencing such a wide range of symptoms that can be difficult to anticipate and manage. It’s important to know that the COVID-19 vaccine may have some mild short term side effects that usually go away within a few days, including:

INSERT SIDE EFFECTS.
Data shows that these side effects are not likely to be more severe for pregnant people or impose any danger to you or your child.

If pushed on pregnant women being excluded from initial vaccine trials:

There is a long history of excluding pregnant women from clinical initial clinical trials even when there is no reason to suggest they are at greater risk.
Since the initial clinical trials of the vaccine there has been significant studies done that have proven not just the safety but the benefits for pregnant people and their babies.

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BARRIER

Getting vaccinated while pregnant is a great way to ensure your own health and safety, the safety of your pregnant, and that of your young infant after birth.
Of course you want what is best and safest for your baby. You are not alone in questioning the safety of the vaccine for your child. In fact, historically pregnant women have been more likely to get vaccines when they are proven to protect their baby after birth.
Vaccines protect people, including pregnant women and infants from the emerging health risks of the COVID-19.
As an unvaccinated population infants can receive protection from the virus during pregnancy for up to their first six months of life, when they are the most vulnerable to a wide range of illnesses.
In fact, a brand new study found that vaccination during pregnancy can protect infants from hospitalization due to COVID-19 side effects and symptoms for up to six months, when they are the most vulnerable to a wide range of illnesses.
As the pandemic continues on and new variants continue to arise, despite your best efforts to keep your baby safe, it has become increasingly more difficult to control exposure to the virus. What is possible is to offer your infant protection by getting vaccinated during pregnancy.
By offering protection against COVID-19, the vaccine has also proven to allow for a healthy pregnancy and delivery and actually improves maternal and infant outcomes.

There is indisputable evidence that the vaccine is not only safe for pregnant people and their babies but can potentially have life-saving benefits for you and your child.

DANIELA

Getting vaccinated while pregnant is a great way to ensure your own health and safety, the safety of your pregnant, and that of your young infant after birth.

Studies show you are as likely to carry your baby to term with the vaccine as you are without it.

Of course you want what is best and safest for your baby. You are not alone in questioning the safety of the vaccine for your child. In fact, historically pregnant women have been more likely to get vaccines when they are proven to protect their baby after birth.
Vaccines protect people, including pregnant women and infants from the emerging health risks of the COVID-19.
As an unvaccinated population infants can receive protection from the virus during pregnancy for up to their first six months of life, when they are the most vulnerable to a wide range of illnesses.
In fact, a brand new study found that vaccination during pregnancy can protect infants from hospitalization due to COVID-19 side effects and symptoms for up to six months, when they are the most vulnerable to a wide range of illnesses.

The new study is the first real-world, epidemiological evidence that maternal vaccination can protect infants from COVID-19, likely because they are born carrying their mother’s antibodies.
Overall, maternal vaccination was 61% effective at preventing infant hospitalization, the researchers found.
Vaccination later in pregnancy – after the first 20 weeks – appeared to provide better protection for infants than earlier vaccination, the study suggests.

As the pandemic continues on and new variants continue to arise, despite your best efforts to keep your baby safe, it has become increasingly more difficult to control exposure to the virus. What is possible is to offer your infant protection by getting vaccinated during pregnancy.
By offering protection against COVID-19, the vaccine has also proven to allow for a healthy pregnancy and delivery and actually improves maternal and infant outcomes.
If pushed on risk of COVID-19 to pregnant people:

Research has shown that COVID-19 can increase the risk of a variety of pregnancy complications, including preterm birth and stillbirth, while the vaccine has proven to be entirely safe.

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ASK

You know what is best for you and your baby. I can offer you the best information to make your decision. What I can tell you is that the science is clear – the vaccine is safe and provides great benefits to your health, your pregnancy, and your baby after birth.
As a [insert title], I would never put the health and safety of your child at risk. I am here to share the facts and the science and answer any questions you have. Based on the facts, I recommend getting vaccinated but the decision is completely up to you.
What questions can I help answer so that you can make the most informed decision for you and your child?

The decision is completely up to you, we are here to give you the facts and simply ask that you consider them and what is best for you. What questions do you have that I can help answer?

This one is a bit tricky. In an ideal world the ask would simply be, get vaccinated.

The science shows we need to be moving from recommending it to encouraging it.

But the research shows we need to preserve autonomy and make sure the women know they are experts of thier own bodies and its really up them.

You know what is best for you and your baby. I can offer you the best information to make your decision. What I can tell you is that the science is clear – the vaccine is safe and provides great benefits to your health, your pregnancy, and your baby after birth.
As a [insert title], I would never put the health and safety of your child at risk. I am here to share the facts and the science and answer any questions you have. Based on the facts, I recommend getting vaccinated but the decision is completely up to you.
What questions can I help answer so that you can make the most informed decision for you and your child?

If asked and it is applicable and appropriate:

I trust the science personally, when I had the choice to vaccinate my own children - [insert ages] I decided to do so and I am so grateful that I did, it has offered a huge sense of relief as they continue to be exposed but protected [in school, in day care, at college, etc].

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VISION

At the end of the day, my goal as you [insert title] is to have a healthy mom and a healthy baby.
Based on the science, what I have seen day to day here at [insert name of health center and/or region], and [insert my own experience if relevant] having the COVID-19 vaccine can help keep mom and baby healthy.
We can help take one less worry off your plate by getting you vaccinated today.

If asked where or how to get a vaccine and if it requires insurance be prepared with the closest location, appointment availability and processes, and if possible help them schedule the appointment.
If you’re not ready, take all the time you need to consider what you learned today, and feel free to keep coming to see me or follow up with more questions. Let’s keep this conversation going.

We share the goal of ensuring you have the safest pregnancy possible and a healthy baby. Getting vaccinated against the COVID-19 can help ensure that safety.

DANIELA

At the end of the day, my goal as you [insert title] is to have a healthy mom and a healthy baby.
Based on the science, what I have seen day to day here at [insert name of health center and/or region], and [insert my own experience if relevant] having the COVID-19 vaccine can help keep mom and baby healthy.
We can help take one less worry off your plate by getting you vaccinated today.

If asked where or how to get a vaccine and if it requires insurance be prepared with the closest location, appointment availability and processes, and if possible help them schedule the appointment.
If you’re not ready, take all the time you need to consider what you learned today, and feel free to keep coming to see me or follow up with more questions. Let’s keep this conversation going.

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Questions?

Tighten up the messaging

Maybe just do top 4 messages?
How to present to focus group?
How to address vaccine hesitancy among practitioners - even in focus groups
Not a space to debate the science - its their role to believe the science - right tone - everyone is entitled into their own opinion
Not wrong to exercise caution or judgement - nevertheless - MESSAGING TO MESSENGER not just what they will carry
Protects against pre-term - article from yesterday - anecdotally people think they’ve seen more pre-term women who have gotten vaccinated - not statistically correct but concern is there - FEAR OF PRE-TERM
DOCUMENTED IN CHW literature - CHW’s, any person who does health education - says something as part of thier job that wouldn’t apply (smoking - example) - when it’s inauthentic - people don’t receive it - you know what, i was hesitant too then i realized
Schedule call with mirelle on facilitation -

Sources of research - without shaming - what has worked/what has shifted

DANIELA - SOME LANGUAGE Q’S WE HAD:

Pregnant people or women?

Child, baby?

Infant vs new born?

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