Factors Influencing COVID-19 Vaccine Acceptance and Hesitancy among Pregnant Women in Nigeria

Background Vaccine hesitancy has been a serious public health concern. Pregnant women are at higher risk of developing complications related to COVID-19 infections and other infectious diseases. These complications can lead to poor outcomes for infants. This study assessed the level of hesitancy of COVID-19 vaccination among pregnant women in Nigeria.

A hospital-based cross-sectional study was conducted among 104 pregnant women at the Plateau State Specialist Hospital antenatal clinic. A semi-structured data collection tool of 15 items was used to assess participants’ COVID-19 vaccine hesitancy, with scores below the mean indicating hesitancy. Data were collected and managed using the Research Electronic Data Capture (REDCap). Descriptive analyses and binary logistic regression were done using Stata MP 18, and a significant p-value was set at <0.05.

The mean age of the participants was 30.3 (SD 6.3) years, with less than half (49%) falling within the 25-34 age group. Majority (96.2%) of the participants were married, resided in the urban area (84.6%) and were employed (64.4%). More than half of the participants had more than one child (72.1%), were healthy (55.8%) and had no family members or friends who had taken the COVID-19 vaccine (70.2%). About 71% of the participants had a positive perception of the COVID-19 vaccine. The overall mean score for vaccine hesitancy among participants was 3.0 (S.D 1.6), with 57.7% hesitating to the COVID-19 vaccine. Participants with more than one child (aOR = 3.31, 95%CI=1.17-9.42), in healthy condition (aOR = 3.95, 95%CI=1.55-10.07), had family and friends who had received COVID-19 vaccine (aOR = 3.27, 95%CI=1.07-10.00) and Negative perception on COVID-19 vaccine (aOR = 4.16, 95%CI=1.05-16.57) had more likelihood to the hesitancy of COVID-19 vaccine.

Nearly three out of five pregnant women in our study expressed COVID-19 vaccine hesitancy. Pregnant women were more likely to be hesitant to COVD-19 vaccines if the felt their health was good and had a family member that had received a COVID-19 shot. Public health efforts and education campaigns for pregnant women are needed to change their perception patterns in promoting vaccination uptake and inclusion in vaccine trials. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study was funded by NIH 3U01HD094658-05S1 Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Plateau state Specialist Hospital Jos Local institutational review board. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present study are available upon reasonable request to the authors