Coverage and Determinants of COVID-19 Vaccination Among Pregnant Women: An Experience From a Low-Income Country.

PURPOSE: to determine COVID-19 vaccination coverage among pregnant women and investigate the factors affecting vaccine uptake. DESIGN: Analytical cross-sectional study. SETTING: Palestinian health care facilities. Between October and November 2021 - eight months after the country's first COVID-19 vaccination. SAMPLE: We needed 820 people to estimate vaccination coverage among pregnant women with a precision rate of 3%. Therefore, we invited 950 pregnant Palestinian women who were eligible and had a response rate of 91.6%. MEASURES: An interviewer-administered questionnaire examined vaccination uptake, attitudes, and concerns about the COVID-19 vaccine. ANALYSIS: Bivariable and multivariable analysis using SPSS. RESULTS: vaccination uptake was reported by 219 pregnant women [25.5%, 95% CI: 22.6% -28.5%]. Knowledge (aOR=2.0; 95% CI: 1.2-3.1), perceived benefits (aOR=1.1; 95% CI: 1.06-1.16), employment (aOR=5; 95% CI: 3.1-8.1), and underlying medical condition (aOR=2.1; 95% CI: 1.1-4.1) predicted uptake. Reporting vaccine barriers reduces vaccine uptake (aOR=.92; 95% CI: .89-95). CONCLUSIONS: Pregnant women's COVID-19 vaccination rates are low. Concerns regarding the COVID-19 vaccine for infants affected their decision. COVID-19 vaccination regulations and legislative nudges drove maternal vaccination. Vaccine fears and misconceptions among pregnant women should be addressed.

Perceived barriers to Palestinian pregnant women's acceptance of COVID-19 vaccination using the Health Believe Model: a cross-sectional study.

This study aims to explore pregnant women's attitudes to COVID-19 vaccination and determinants of vaccine acceptance. We conducted a cross-sectional study among pregnant women attending PHC clinics and hospitals in the West-bank of Palestine. We used an interviewer-administered questionnaire based on Health Belief Model. The study's primary outcome was COVID-19 vaccination acceptance. We used the Chi-square test to compare those who accepted the vaccine versus those who refused it and conducted binary logistic regression to explore independent determinants of vaccination acceptance. Among the 728 pregnant women who took part in the study, 20.7 percent showed positive attitudes (acceptance) toward COVID-19 vaccination. Employment (aOR 4.0; 95 percentCI: 2.2-7.3), a history of COVID-19 (aOR 1.9; 95 percentCI: 1.2-3.1), and having a relative who died from COVID-19 (aOR 2.3; 95 percentCI: 1.2-4.7) increased the likelihood of vaccine acceptance, as did vaccine perceived effectiveness (aOR 1.9; 95 percentCI: 1.2-3.2) and perceived protection from severe disease (aOR 2.0; 95 percentCI: 1.2-3.5). On the other hand, perceived limited access (aOR 0.540; 95 percentCI: 0.31-0.87) and perceived harm to the baby (aOR 0.346; 95 percentCI 0.22-0.54) remained the main barriers toward vaccine acceptance. In conclusion, pregnant women's acceptance of the COVID-19 vaccine is unsatisfactory. Concerns about its effect on unborn babies were major barriers to vaccination.