Provider Communication and Vaccine Acceptance: Analysis of Vaccine Conversations Between Pregnant Women and Health Care Providers

Objective: To understand the dynamics of vaccination conversations between obstetrician/gynecologists and pregnant women and the factors influencing vaccine acceptance and differences by patient race and ethnicity. Methods: In this qualitative study we used linguistic analysis to analyze vaccination conversations between 40 unique patients and 10 unique providers from the 2020 to 2021 influenza season. The results were stratified for non-Hispanic White (“White”) patients compared to non-Hispanic Black and Hispanic patients (“patients of color/POC”) to assess differences in the strength of provider vaccine recommendations, initiation of vaccination conversation, the patient reaction to vaccination prompts, and association of these factors with vaccination intent as the primary outcome. Results: The linguistic analysis demonstrated that 22 (55%) out of 40 patients intended to get vaccinated. More POC delayed or refused influenza vaccination (3/6) than White patients (2/10), while more White patients (5/5) than POC demonstrated intent to get the Tdap vaccine (6/10). While providers consistently explained the value of vaccination, greater emphasis was placed on communicating the benefits of Tdap compared with influenza vaccination to POC. Providers used fewer techniques indicative of strong vaccine recommendations when recommending influenza vaccination to POC compared with White patients. Conclusion: This hypothesis-generating study suggests some aspects of provider communication about prenatal vaccination may differ by patients’ race and ethnicity. Provider-based interventions to improve communication with pregnant women about prenatal vaccines may improve vaccine uptake and reduce racial and ethnic disparities.