Table 3 Selected interviewee responses mapped to subthemes within the COM-B framework
COM-B | Subtheme | Sample of responses |
|---|---|---|
Psychological capabilitya | Consistency and reliability of COVID-19 vaccine information and research | “It was the change so quick. With my first baby, it was 'No, don't get it,', like no chance, and then all of a sudden the same midwives are saying, 'You need to get it.' In a short space of time you can say it's safe” (Interviewee 5, 25 – 29 years) “I personally don't know what's going into a vaccine… and I don't think it's been researched enough—what could happen if a pregnant woman gets the vaccine, what it could do to her body, what it could do to her baby. It's different when you're the average person, not pregnant…” (Interviewee 6, 18 – 24 years) [trust in safety of other vaccines as]…”they've been around long enough, there's enough research into them” (Interviewee 8, 30 – 34 years) |
Balancing authentic and accessible risk–benefit information and choice-framing | “There's a lot of medical terminology and jargon and stuff and if you had, if it was laid out in more layman's terms, this is the research, this is the statistics, good and bad, because there's no point in hiding the bad, if there is going to be a risk, then name what the risk is… I think the more transparent you are, the more likely people are to be accepting of something…” (Interviewee 2, 35 – 45 years) “If they were able to say, 'All these babies have been born and they've been fine, and if you don't get it, your baby could be very, very sick,' but they couldn't back any of these things up, there was no solid information on side effects. It was just saying 'None we know of,'…” (Interviewee 5, 25 – 29 years) “I think in your pack, have the information and the leaflets about the injections and the thing, go, 'Look, this is what's offered to you during pregnancy, it's totally optional, what do you want to do? Go home, have a look over it, read over it, and make your own mind up and it'll tell you on your leaflet you book that with your doctors at such-and-such a date'” (Interviewee 8, 30 – 34 years) | |
Social opportunityb | Persuasion of personal relatedness | “..it was my mum, who now has, or is going last month or this month to see about having long COVID… and she's like, 'Do not get your vaccine, do not get it, I'm telling you, don't do it, especially in pregnancy'” (Interviewee 3, 18 – 24 years) “…maybe studies where you've interviewed women that have had babies and interviewed women that have it, then maybe just done a study on the wee ones that are born then after, their own health and their own behaviours” (Interviewee 4, 30 – 34 years) “I would've been a big TikTok person back then, you know, and that's where you would hear people's personal stories on what they were going through. There was a woman I think, and she had COVID. No, she wasn't pregnant or anything, but she had to learn how to walk again, she had to learn how to talk again, she got so ill after 3 days of having the vaccine and I just thought, like if that's because of the vaccine, that's weird …” (Interviewee 6, 18 – 24 years) |
Trust in health professionals and professional organisations | “…I feel like I really did trust them [midwife] as much as anybody else, because they were there to help me and help my baby throughout that. Covid or not Covid, your midwives are there to support you” (Interviewee 7, 25 – 29 years) | |
Physical opportunityc | Vaccine delivery within familiar healthcare pathways | “They had a drop-in in (town) for pregnant women so I felt even safer going to that. I was like, excellent, it's going to be all people, same situation as me, everyone's going to be cautious” (Interviewee 1, 30 – 34 years) “I think those mobile vaccine clinics were brilliant, really. I think they should keep them actually because they were very, very good and they should have, it shouldn't be tedious when you go to your whatever, appointment, your 20 week appointment or whatever, you're just, it's a one stop shop really” (Interviewee 2, 35 – 45 years) |
Reflective motivationd | Unnerved by the unknown (vaccine risk and safety) | “It was probably fear of the unknown and not really for me as such, but more for my baby …” (Interviewee 2, 35 – 45 years) “It was a decision I didn't make lightly, and I think I changed my mind about 20 times back and forth and back and forth, but in the end, it was just that I didn't want to take a vaccine that I didn't know if it would then in a few years' time come back to say, 'Your baby has this because you took the vaccine.'..” (Interviewee 4, 30–34 years) “Because the baby's supposed to be getting all your antibodies and everything that they need through you, through you eating and being healthy and whatever. So, because it was so uncertain at the time, you don't know what benefits there were of you getting the vaccines, and what benefits it would have on the baby” (Interviewee 5, 25 – 29 years) “…people were getting the vaccine and still getting COVID so it's not as if it prevented it” (Interviewee 6, 18–24 years) “The only benefit that they told me was if I was to catch COVID I would have had less chance to have been hospitalised but healthy people are on a low risk anyway of being hospitalised with COVID-19 anyway” (Interviewee 8, 30 – 34 years) |
Confidence in personal health agency | “If I was pregnant and contracted a virus, my view would have been, and this may be wrong, it's nearly better because then the baby develops a particular immunity” (Interviewee 2, 35 – 45 years) “Once I got that last thing of COVID, I was like, 'I don't know, I maybe should have got my vaccine.' That's when the guilt sort of hit in” (Interviewee 3, 18 – 24 years) “I feel it's a very personal choice. I do feel it's a very personal choice, and I think you can give all the information in the world, but if it doesn't sit right, it doesn't sit right. As I say, I was given every bit of information and everybody around me, but it just didn't sit right with me” (Interviewee 4, 30 – 34 years) | |
Automatic motivatione | Fear drives indecision | “I definitely felt like they were telling me to take it and that Covid-19 wasn't going anywhere, and that really, I had a decision to make but really, I should do that quite quickly because there were pregnant women who had had it and were in ICU… And I kept saying that I didn't want to put my baby at risk” (Interviewee 7, 25 – 29 years) |
Feeling unheard and cornered | “They didn't really tell me much about the vaccine itself, to be honest. It was more, 'Have you had your vaccines?' Patronising more, you know, very patronising..” (Interviewee 3, 18 – 24 years) “Anybody who's not pregnant during that won't know the internal turmoil of that and to get to a decision really should have a lot of respect…” (Interviewee 7, 25 – 29 years) “there was one of the girls, the community midwives in the thing, my partner he had come to pick me up and I actually came out crying because she pressurised me that much, she kept going to me, 'You know it's not just you, you have to think about anymore? You have a baby inside you” (Interviewee 8, 30 – 34 years) |