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

Osawe, S.; Olasunkanmi, Y.; Salawu, M. M.; Okedare, O. O.; Okolo, F.; Babamale, S.; Onyemata, J.; Adenekan, T.; Abdullahi, A.; Abimiku, A.

2025-11-06 epidemiology
10.1101/2025.11.03.25338963 medRxiv
Show abstract

BackgroundVaccine 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. MethodA 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. ResultsThe 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. ConclusionNearly 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.

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