To the Editor,

It is evident that pregnant women and babies have suffered damage throughout the Coronavirus disease-2019 (COVID-19) pandemic (1). Hence, immunization is critically important for pregnant women. The American College of Obstetricians and Gynecologists recommends that all eligible individuals over the age of 12 years, including pregnant and breastfeeding women, receive a COVID-19 vaccine or series of vaccines (2). Although evidence on the safety of COVID-19 vaccinations in pregnancy is limited, high-quality findings demonstrate its reliability, and further evidence emerges day by day (3). Nevertheless, despite all available knowledge and the positive findings of the research, the concerns and rejection of COVID-19 vaccination by pregnant women is a critical issue that should be addressed.

We conducted a survey to assess whether pregnant women would trust the vaccine or not, even though human and/or animal experiments proved the safety and efficiency. The survey was conducted face-to-face with pregnant women who were admitted to our obstetrics outpatient clinic between February and April 2021. Five hundred and eight pregnant women agreed to participate in the survey.

We found that 50.8% of pregnant women do not want to be vaccinated during pregnancy. Even if animal experiments have proven the safety of the vaccine, 90% of these unwilling women still do not want to be vaccinated. Only 3.8% of these women changed their opinions positively. However, if the reliability of the vaccine was proven in human subject research, 24.8% of them would reconsider their refusal to be vaccinated. The biggest concern of women regarding the vaccination is that they are pregnant. If these women had not been pregnant, only 37% would have refused vaccination. The primary concerns of the participants were preterm birth (29.2%) and miscarriage (26.2%). The idea of harm to the fetus was a concern of only a small proportion of the women. When pregnant women begin breastfeeding, the rate of refusal to be vaccinated reduced to 20.3%. In addition, 45.3% of the participants believe vaccines will not be successful. If Turkey produced its own vaccine, the rate of participants who accept vaccination rises to 57.7%.

Inadequate data, health policies, and agendas create distrust in pregnant women against vaccines. The two most common concerns of pregnant women are premature birth and miscarriage. It is clear that additional studies, especially those conducted during the early pregnancy, including the preconception period and long-term follow-up, are significantly necessary. Producing a vaccine improves pregnant women’s confidence in countries where nationalism is prominent owing to sociopolitical positions, such as in Turkey.

This current study was approved by the Institutional Review Board (no: E-12405952-050.05.04-115097) and was performed under the rules of the Declaration of Helsinki. The patients have given their informed consent for the manuscript to be published.