Knowledge, attitudes, and practices of pregnant women regarding COVID‐19 vaccination in pregnancy in 7 low‐ and middle‐income countries: An observational trial from the Global Network for Women and Children’s Health Research

Abstract

Objectives We sought to determine the knowledge, attitudes and practices of pregnant women regarding COVID‐19 vaccination in pregnancy in seven low‐ and middle‐income countries (LMIC). Design Prospective, observational, population‐based study. Settings Study areas in seven LMICs: Bangladesh, India, Pakistan, Guatemala, Democratic Republic of the Congo (DRC), Kenya and Zambia. Population Pregnant women in an ongoing registry. Methods COVID‐19 vaccine questionnaires were administered to pregnant women in the Global Network's Maternal Newborn Health Registry from February 2021 through November 2021 in face‐to‐face interviews. Main outcome measures Knowledge, attitude and practice regarding vaccination during pregnancy; vaccination status. Results No women were vaccinated except for small proportions in India (12.9%) and Guatemala (5.5%). Overall, nearly half the women believed the COVID‐19 vaccine is very/somewhat effective and a similar proportion believed that the COVID‐19 vaccine is safe for pregnant women. With availability of vaccines, about 56.7% said they would get the vaccine and a 34.8% would refuse. Of those who would not get vaccinated, safety, fear of adverse effects, and lack of trust predicted vaccine refusal. Those with lower educational status were less willing to be vaccinated. Family members and health professionals were the most trusted source of information for vaccination. Conclusions This COVID‐19 vaccine survey in seven LMICs found that knowledge about the effectiveness and safety of the vaccine was generally low but varied. Concerns about vaccine safety and effectiveness among pregnant women is an important target for educational efforts to increase vaccination rates.

Factors Affecting Willingness to Vaccinate COVID-19 in Pregnant Women in Manggarai Regency, East Nusa Tenggara, Indonesia

“…The results of this study are in line with Naqvi et al (2022), where the majority of pregnant women who believe the COVID-19 vaccine is very effective are willing to be vaccinated. Pregnant women who refuse to be vaccinated have the characteristics of a low level of education.…”

Choices facing pregnant women regarding COVID‐19 vaccination

“…Concerns regarding vaccine safety and effectiveness among pregnant women are an important focus for educational efforts to boost immunisation rates. 1 We agree that vaccine knowledge is a key component in deciding vaccination acceptance. Concerns about vaccine safety are often cited as the primary factor for hesitation.…”

“…We congratulate Naqvi et al 1 on their study that reports knowledge, attitudes and practices of pregnant women regarding COVID‐19 vaccination, from the Global Network for Women and Children’s Health Research. 1 …”

Variability in COVID‐19 vaccination rates in pregnant women: Vaccine hesitancy or supply limitations?

“…Our study found that in a number of countries, many pregnant women claimed to have little information related to vaccine effectiveness and safety. 2 We should reiterate that the US CDC has concluded that for pregnant women, the vaccine is safe and effective and that, with few exceptions, all women should be vaccinated. Sookaromdee and Wiwanitkit also note that the COVID‐19 vaccination story is still evolving.…”

“…In our paper, across eight Global Network sites including those from sub‐Saharan Africa, overall, about one‐third of the pregnant women said they would refuse COVID‐19 vaccination, mostly due to concerns related to safety and effectiveness. 2 However, the majority said they would accept COVID‐19 vaccination if available. Thus, we agree that it is important to distinguish concerns regarding vaccine hesitancy where vaccine is available, often in the more developed countries, compared with the lack of vaccine, such as seen in many areas of sub‐Saharan Africa.…”