Acceptance of a COVID 19 vaccine and associated factors among pregnant women in China: a multi center cross sectional study based on health belief model
ABSTRACT Background: Vaccine hesitancy has been recognized as an urgent public health issue. We aimed to explore the acceptance of a COVID 19 vaccine and related factors among pregnant women, a vulnerable population for vaccine preventable diseases. Methods: A multi center cross sectional study among pregnant women was conducted in five provinces of mainland China from November 13 to 27, 2020. We collected sociodemographic characteristics, attitude, knowledge, and health beliefs on COVID 19 vaccination. Locally weighted scatterplot smoothing regression analysis was used to assess the trends of vaccination acceptance. Multivariable logistic regression was performed to identify factors related to vaccination acceptance. Results: Among the 1392 pregnant women, the acceptance rate of a COVID 19 vaccine were 77.4% (95%CI 75.1 79.5% In the multivariable regression model, the acceptance rate was associated with young age (aOR 1.87, 95% CI: 1.20 2.93) western region (aOR 2.73, 95% CI: 1.72 4.32) low level of education (aOR 2.49, 95% CI: 1.13 5.51) late pregnancy (aOR 1.49, 95% CI: 1.03 2.16) high knowledge score on COVID 19 (aOR 1.05, 95% CI: 1.01 1.10) high level of perceived susceptibility (aOR 2.18, 95% CI: 1.36 3.49) low level of perceived barriers (aOR 4.76, 95% CI: 2.23 10.18) high level of perceived benefit (aOR 2.18, 95% CI: 1.36 3.49) and high level of perceived cues to action (aOR 15.70, 95% CI: 8.28 29.80) Conclusions: About one quarters of pregnant women have vaccine hesitancy. Our findings highlight that targeted and multipronged efforts are needed to build vaccine literacy and confidence to increase the acceptance of a COVID 19 vaccine during the COVID 19 pandemic, especially for vulnerable populations.
Human vaccines immunotherapeutics