High Intention to Vaccinate Against Tuberculosis During Pregnancy and Lactation: Understanding Vaccine-specific Maternal Immunization Acceptance in Amhara, Ethiopia

Abstract

Background: Tuberculosis (TB) disease during pregnancy results in adverse maternal and infant outcomes. The development of a TB vaccine with potential for administration during pregnancy or lactation is a priority identified by the World Health Organization. We assessed the acceptability of vaccines currently administered during pregnancy [tetanus, diphtheria and COVID-19] and willingness to receive a new TB vaccine during pregnancy and/or lactation among Ethiopian women.

Methods: From January to February 2022, we conducted surveys among pregnant women receiving antenatal care at 20 hospitals in Amhara, Ethiopia. We evaluated uptake of available vaccines (diphtheria), acceptance of new and future vaccines (COVID-19 and TB) during pregnancy and lactation, and knowledge, attitudes and beliefs associated with vaccine-specific acceptance.

Results: Among 200 participants, we found high intention to receive a TB vaccine during pregnancy (90%) and lactation (92%) and low COVID-19 vaccine acceptance during pregnancy (40%) and lactation (47%). Most participants believed TB vaccination would protect their child from disease (82.5%) and have societal benefits (81.5%), while few women perceived the COVID-19 vaccine to offer protection (35.5%) or have societal benefits (42.5%). Intention to receive TB vaccination during pregnancy was associated with the belief that a future maternal TB vaccine would prevent TB among infants (adjusted prevalence ratio 1.37, 95% CI: 1.10-1.70). Most participants reported high acceptability of educational interventions to increase uptake of maternal immunization.

Conclusions: We found high intention to receive a new TB vaccine during pregnancy and lactation among Ethiopian women. Our findings support vaccine-specific educational interventions to strengthen maternal immunization programs in Ethiopia.