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Multicenter Study
. 2024 Dec 31;20(1):2383030.
doi: 10.1080/21645515.2024.2383030. Epub 2024 Jul 31.

Factors influencing vaccine acceptance in pregnancy during the COVID-19 pandemic: A multicenter study from West Bengal, India

Tila Khan  1 , Ranjan Saurav Das  1 , Mithu Jana  1 , Sangeeta Das Bhattacharya  1 , Sayantan Halder  1 , Sabyasachi Ray  2 , Parthasarathi Satpathi  3 , Tarapada Ghosh  4 , Krishnendu Mukherjee  5 , Shubhendu Pal Choudhury  6
Affiliations
Multicenter Study

Factors influencing vaccine acceptance in pregnancy during the COVID-19 pandemic: A multicenter study from West Bengal, India

Tila Khan et al. Hum Vaccin Immunother. .

Abstract

Influenza, COVID-19, tetanus, pertussis and hepatitis B pose increased risk for pregnant women and infants and could be mitigated by maternal immunization. In India Tetanus-diphtheria (Td) and COVID-19 vaccines are recommended during pregnancy, while influenza and tetanus-acellular pertussis-diphtheria (Tdap) vaccines are not. We conducted a multicenter study from November 2021 to June 2022 among pregnant women (n = 172) attending antenatal clinics in three public hospitals in West Bengal, to understand the factors that influence women's decisions to get vaccinated during pregnancy. Questions assessed vaccination coverage, knowledge, intention and willingness to pay for influenza vaccine, and factors influencing decisions to get Td, influenza, and COVID-19 vaccines. 152/172 (88.4%) women were vaccinated with Td, 159/172 (93%) with COVID-19, 1/172 (0.6%) with influenza, and none with Tdap. 10/168 (6%) had received hepatitis B vaccine (HBV). Community health workers advice was crucial for Td uptake and, the belief of protection from COVID for COVID-19 vaccines. Most women were unaware about Tdap (96%), influenza (75%), and influenza severity during pregnancy and infancy (85%). None were advised for influenza vaccination by healthcare providers (HCP), albeit, 93% expressed willingness to take, and pay INR 100-300 (95% CI: ≤100 to 300-500) [$ 1.3-4.0 (95% CI: ≤1.3, 4-6.7)] for it. Vaccination on flexible dates and time, HCP's recommendation, proximity to vaccination center, and husband's support were most important for their vaccination decisions. Women were generally vaccine acceptors and had high uptake of vaccines included in the Universal Immunization Program (UIP). Inclusion of influenza, Tdap, and HBV into UIP may improve maternal vaccine uptake.

Keywords: COVID-19; India; hepatitis B; influenza; pertussis; pregnant women; tetanus; vaccination; vaccine acceptance.

Plain language summary

Vaccinations during pregnancy protect mothers and babies from lethal infections from tetanus, influenza, COVID-19, pertussis, and hepatitis B. In India all pregnant women get tetanus (Td) vaccines, and during the pandemic, pregnant women got COVID-19 vaccines as part of the government program. We conducted a study among pregnant women attending three public hospitals in West Bengal, India, during the COVID-19 pandemic to understand the factors that influence women’s decisions to get vaccinated during pregnancy. We found that most pregnant women had gotten Td (88.4%) and COVID-19 (93%) vaccines; however, the uptake was low for influenza (0.6%), pertussis (0%), and hepatitis B vaccines (6%) which are all not available in government programs. Though the majority (92%) of women had not heard about influenza vaccines, once they learnt about them, 93% said they would get vaccinated and even pay for it. Vaccination at flexible times and their doctor’s advice were important in their decisions to get vaccinated. Our research builds the case to include influenza, pertussis, and hepatitis B vaccines in programs for pregnant women.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Geographic location of study participants.
Figure 2.
Figure 2.
Participants’ understanding about maternal immunization, N = 172.
Figure 3.
Figure 3.
COVID-19 awareness among study participants.
Figure 4.
Figure 4.
Vaccination status of study participants.
Figure 5.
Figure 5.
Reasons for taking tetanus toxoid vaccine and COVID-19 vaccine.
Figure 6.
Figure 6.
Willingness-to-pay for influenza vaccination by the study participants in USD, n = 157 the bars represent the percent responses for their willingness-to-pay for one dose of influenza vaccine starting from upto 1.3 USD to 20–26.7 USD.
Figure 7.
Figure 7.
Trust.
Figure 8.
Figure 8.
Cues for maternal vaccine uptake, n = 172.
See this image and copyright information in PMC

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