ABSTRACT
Background. Little is known about the factors which influence COVID-19 vaccine uptake among reproductive-aged women in Jamaica. Methods. We conducted a cross-sectional, web-based survey of 192 reproductive-aged women in Jamaica from February 1- 8, 2022. Participants were recruited from a convenience sample of women (patients, providers and staff) at a tertiary care hospital whose demographic characteristics are shown in Table 1. We assessed self-reported COVID-19 vaccination status, vaccine confidence (defined as confidence in the safety and efficacy of vaccines and the system that delivers them) and medical mistrust beliefs (e.g., "I don't trust the COVID-19 vaccine"). We conducted exploratory factor analysis using principal axis factoring and oblique equamax rotation on 22 survey items. Three factors were extracted which conceptually aligned with three subscales: lack of vaccine confidence, government-related COVID-19 medical mistrust, and race-based COVID-19 medical mistrust;we retained items with factor loadings > 0.40. The final subscale variables and their descriptive statistics are shown in Table 2. In addition, we used multivariable modified Poisson regression to calculate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for the association between vaccine uptake and pregnancy status adjusting for education and factors scores. Variables with a p value < 0.1 were retained in the final regression model. Results. Of 192 respondents, 72(38%) were pregnant and 120 (62%) were nonpregnant. Pregnancy was negatively associated with vaccine uptake (aPR=0.70, 95% CI=0.51 - 0.96;p=0.029). Women with higher scores on the lack of vaccine confidence subscale (i.e., less confident in vaccine) were less likely to be vaccinated (aPR=0.72, 95%CI=0.61 - 0.86;p< 0.001). Government-related COVID-19 medical mistrust and race-based COVID-19 medical mistrust were not significantly associated with vaccine uptake (see Table 3). Conclusion. Findings suggest that pregnancy and lack of vaccine confidence are factors associated with lower vaccine uptake among reproductive-aged women in Jamaica. Bolstering vaccine confidence, through the use of evidence-based interventions, may help to increase COVID-19 vaccine uptake in this population.