Determinants of COVID-19 Vaccine Hesitancy Among Pregnant Women in Baldia Town, Karachi, Pakistan, July–November 2021; a Case-control Study
Background: Pakistan is among the countries with a very high burden of maternal mortality. Since the introduction of COVID-19 vaccination, millions of pregnant women have been vaccinated and have been found safe. The scientific evidence has revealed that mortality due to COVID-19 infection during pregnancy increased 22 folds. In Pakistan, vaccination for pregnant women was initiated in May 2021. This study aims to evaluate the determinants of vaccine hesitancy and to formulate recommendations to enhance vaccine uptake.
Methods: A case-control study was conducted from July 1–November 30, 2021, in Baldia Town, Karachi. A case was defined as any pregnant woman, hesitant to receive COVID-19 vaccination, resident of Baldia Town from July 1–November 30, 2021, while neighborhood pregnant women consenting for COVID-19 vaccination were taken as control. Cases were identified from the health worker information system. After that verbal consent face-to-face interviews were conducted. A pre-structured questionnaire was developed to collect demographic, clinical, and risk factors information. Logistic regression was applied to calculate aOR at 95% CI and p-value <0.05.
Results: A total sample size of 104 was obtained. Of 52 cases median age was 32 years (range=17–47 years). In most of the cases 29 (56%) were reported among the 31–40 years, age group. On logistic regression, fear of possible side effects (aOR=2.17; CI=1.44–12.48) and family pressure (aOR=1.93; CI=1.35–11.21) were significantly associated with vaccine hesitancy. While women <30 years and with higher education were found willing to vaccinate.
Conclusions: Our study found that family pressure and fear of possible side effects were most significantly associated with vaccine hesitancy. Young age and higher educational levels were instrumental in better vaccine acceptance. It is recommended to raise awareness regarding the associated side effects and the relative benefits of getting vaccinated through risk communication targeted at the whole family.