Adherence to COVID-19 Recommendations and Vaccination Among Pregnant Women and New Mothers in Sweden

Background

The COVID-19 pandemic was a global public health crisis that affected everyone, including pregnant women and new mothers. Previous research suggests this population adhered well to COVID-19 recommendations, though vaccine uptake was limited due to safety concerns. Sweden’s largely voluntary and less restrictive pandemic response provided a unique context to study adherence and vaccination patterns. The aim was to examine adherence to infection prevention measures and COVID-19 vaccination among pregnant women and new mothers.

Methods

We conducted a longitudinal study using data from the prospective population-based NorthPop Birth Cohort Study in Sweden. Repeated questionnaires on adherence to infection prevention measures and COVID-19 vaccination were distributed between June 2020 and December 2021.

Results

Pregnant women and new mothers reported high adherence to infection prevention measures, peaking in December 2020 and declining thereafter for most behaviours. Compared with postpartum participants, pregnant women were less likely to limit social contacts (OR = 0.69, 95% CI: 0.49–0.97) and to stay home when experiencing cold symptoms (OR = 0.68, 95% CI: 0.49–0.93). Vaccine uptake was high (94.7%) among all. Participants with at least a university degree were more likely to be vaccinated (OR = 3.04, 95% CI: 1.87–4.92), and the odds of vaccination increased by 9% with each additional year of age (OR = 1.09, 95% CI: 1.03–1.15).

Conclusions

Trust in public authorities and the healthcare system, together with a strong sense of collective responsibility, may partly explain the high adherence to recommendations and COVID-19 vaccine uptake among pregnant women and new mothers during the COVID-19 pandemic in Sweden. Sociodemographic differences in vaccine uptake highlight the need for targeted communication and support. These findings provide insights relevant for future pandemic preparedness and maternal health policy across Europe.

Key messages

• Pregnant women and new mothers in Sweden reported high adherence to infection prevention measures during the COVID-19 pandemic, but levels declined over time. Vaccination uptake was also high.

• COVID-19 vaccination uptake was associated with higher education and older age, and policymakers may consider using these insights to guide targeted interventions.