A pregnant healthcare worker refuses COVID-19 vaccination due to fear of long-term complications. Which is the most appropriate response for the infection preventionist?

• A. Give relevant literature to read and follow up next week
• B. Reassign the HCW to another position if they refuse
• C. Inform that vaccination will ensure that they do not develop COVID-19
• D. Inform that vaccination for pregnant employees is recommended by the CDC and they have good data to support these recommendations

Answer: (D)

When guiding a pregnant healthcare worker, use evidence-based guidance and respectful, informative counseling. The best move is to tell them that vaccination for pregnant employees is recommended by the CDC and is supported by robust data. This communicates that the recommendation is current and backed by science, not opinion.

Vaccination during pregnancy has been studied in large populations, and data have not shown an increased risk of miscarriage, preterm birth, or other adverse pregnancy outcomes. The vaccines are non-live, meaning they don’t contain a live virus, which underpins their safety profile in pregnancy. Importantly, getting vaccinated reduces the risk of severe COVID-19 illness, hospitalization, and ICU admission for the mother, which in turn protects both maternal health and, indirectly, the pregnancy course.

It’s important to emphasize that vaccination does not guarantee that a person won’t get infected, but it does lessen the likelihood of severe disease. If the employee has ongoing concerns, offer to review the data together, provide additional resources, and involve occupational health to address questions—without pressuring them to decide immediately.

Other approaches that merely hand over literature, prematurely reassign the employee, or claim that vaccination will completely prevent infection are less appropriate because they either delay informed decision-making, appear coercive, or rely on inaccurate expectations.