Drivers and barriers of vaccine acceptance among pregnant women in Kenya

• Type of Material: Article
• Authors: Nancy A. Otieno, Kenya Medical Research Institute; Fredrick Otiato, Kenya Medical Research Institute; Bryan Nyawanda, Kenya Medical Research Institute; Maxwel Adero, Kenya Medical Research Institute; Winnie N. Wairimu, Kenya Medical Research Institute; Dominic Ouma, Kenya Medical Research Institute; Raphael Atito, Kenya Medical Research Institute; Andrew Wilson, Emory University; Ines Gonzalez Casanova, Emory University; Fauzia Malik, Emory University; Marc-Alain Widdowson, Centers for Disease Control and Prevention; Saad Omer, Emory University; Sandra S. Chaves, Centers for Disease Control and Prevention; Jennifer Verani, Emory University
• Language: English
• Date: 2020-03-21
• Publisher: TAYLOR & FRANCIS INC
• Publication Version: Final Published Version
• Copyright Statement: © 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1080/21645515.2020.1723364
• Title of Journal or Parent Work: HUMAN VACCINES & IMMUNOTHERAPEUTICS
• Volume: 16
• Issue: 10
• Start Page: 2429
• End Page: 2437
• Grant/Funding Information: This work was supported by the Bill and Melinda Gates Foundation [OPP1120377].
• Keywords: vaccine acceptance; INTENTION; MATERNAL IMMUNIZATION; Science & Technology; DISEASE; Immunology; KARACHI; pregnant women; barriers; uptake; Life Sciences & Biomedicine; HESITANCY; drivers; Biotechnology & Applied Microbiology
• Research Categories: Health Sciences, Immunology; Biology, Microbiology

Abstract

Maternal vaccination coverage remains suboptimal globally and is lowest in low- and middle-income countries. Attitudes toward maternal vaccines have been characterized in middle-high income settings, however data from African countries are limited. We assessed drivers and barriers of vaccine acceptance among pregnant women in Kenya. We conducted a cross-sectional survey among pregnant women aged 15–49 y. We enrolled a convenience sample of women presenting for antenatal care at seven health-care facilities in four diverse counties (Nairobi, Mombasa, Marsabit, Siaya) of Kenya and from the community in two counties (Nairobi, Siaya). We described frequencies of socio-demographic characteristics of participants and their knowledge, attitudes, and beliefs regarding maternal vaccination. We enrolled 604 pregnant women with a median age of 26.5 y, of whom 48.2% had primary education or less. More than 95% agreed that maternal vaccines are “important for my health” and that getting vaccinated is “a good way to protect myself from disease”. The most commonly cited reason in favor of maternal vaccination was disease prevention (53.2%). Fear of side effects to mother/baby (15.1%) was the most frequently reported potential barrier. Influenza vaccine is not in routine use in Kenya; however, 77.8% reported willingness to accept influenza vaccination during pregnancy. Maternal vaccination is well accepted among Kenyan pregnant women. We identified the provision of adequate vaccine information and addressing safety concerns as opportunities to improve maternal vaccine uptake. The expressed willingness to receive a vaccine not currently in routine use bodes well for implementation of new maternal vaccines in Kenya.