Journal article

A socio-ecological exploration to identify factors influencing the COVID-19 vaccine decision-making process among pregnant and lactating women: Findings from Kenya

The vaccine decision-making process of pregnant and lactating women is complex. Regarding COVID-19, pregnant women are at increased risk for severe disease and poor health outcomes. While pregnant and lactating women were excluded from COVID-19 vaccine trials, available evidence suggests that COVID-19 vaccines are safe and protective during pregnancy. In this study, we used a socio-ecological approach to explore factors influencing the decision-making process for COVID-19 vaccines in pregnant and lactating women in Kenya, for the purpose of informing demand generation strategies. As pregnant and lactating women are influenced by many factors, we conducted 84 in-depth interviews with a variety of stakeholders, including 31 pregnant or lactating women, 20 healthcare workers such as nurses, midwives, doctors, and frontline workers, 25 male family members of pregnant or lactating women, and 8 gatekeepers such as community leaders and faith-based leaders. These individuals were recruited from six communities in Kenya: three urban, and three rural. We applied a grounded theory approach to identify emerging themes and organized emerging themes using the SAGE Vaccine Hesitancy model, which includes three categories of determinants of vaccine acceptance, including contextual influences, individual and group influences, and vaccine and vaccination specific issues. Myths, interpersonal norms, and religion emerged as themes related to contextual influences. Safety, risk perception, and the role of the healthcare worker emerged as themes related to individual and group influences. For vaccine and vaccination specific issues, emerging themes included availability, accessibility, and eligibility. While maternal immunization can substantially reduce the effect of infectious diseases in mothers and infants, vaccine acceptance is critical. However, vaccines do not save lives; vaccination does. We hope the results of this study can be used to tailor communication efforts to increase vaccine demand among pregnant and lactating women.

Topic references

MIRI-DEMAND

TitleAuthorYearTypeLanguage
“Why has this new vaccine come and for what reasons?” key antecedents and questions for acceptance of a future maternal GBS vaccine: Perspectives of pregnant women, lactating women, and community members in KenyaRupali J. Limaye, Prachi Singh, Berhaun Fesshaye, Clarice Lee, Jessica Schue, Ruth A. Karron2024Journal articleEnglish
A qualitative inquiry in understanding trusted media sources to reduce vaccine hesitancy among KenyansBerhaun Fesshaye, Clarice Lee, Alicia M. Paul, Eleonor Zavala, Prachi Singh, Ruth A. Karron, Rupali J. Limaye2023Journal articleEnglish
A socio-ecological comparison of the COVID-19 vaccine decision- making processes among pregnant and lactating women: Findings from Kenya and BangladeshPrachi Singh, Berhaun Fesshaye, Eleonor Zavala, Clarice Lee, Ruth A. Karron, Rupali J. Limaye2023Poster/infographicEnglish
A socio-ecological exploration to identify factors influencing the COVID-19 vaccine decision-making process among pregnant and lactating women: Findings from KenyaRupali J. Limaye, Alicia M. Paul, Rachel Gur-Arie, Eleonor Zavala, Clarice Lee, Berhaun Fesshaye, Prachi Singh, Wincate Njagi, Paul Odila, Paul Munyao, Rosemary Njogu, Stephen Mutwiwa, Lisa Noguchi, Christopher Morgan, Ruth A. Karron2022Journal articleEnglish
Characterizing Attitudes Toward Maternal RSV Vaccines Among Pregnant and Lactating Persons in Kenya: Key Considerations for Demand Generation Efforts for Vaccine AcceptanceRupali J. Limaye, Molly Sauer, Rosemary Njogu, Prachi Singh, Berhaun Fesshaye, Ruth A. Karron2023Journal articleEnglish
Conceptualizing the COVID-19 Pandemic: Perspectives of Pregnant and Lactating Women, Male Community Members, and Health Workers in KenyaAlicia M. Paul, Clarice Lee, Berhaun Fesshaye, Rachel Gur-Arie, Eleonor Zavala, Prachi Singh, Ruth A Karron, Rupali J. Limaye2022Journal articleEnglish
COVID-19 vaccine decision-making among pregnant and lactating women in BangladeshRupali J. Limaye, Prachi Singh, Alicia M. Paul, Berhaun Fesshaye, Clarice Lee, Eleonor Zavala, Sydney Wade, Hasmot Ali, Hafizur Rahman, Shirina Akter, Ruth A. Karron, Towfida Jahan Siddiqua2023Journal articleEnglish
COVID-19 vaccine eligibility of pregnant and lactating women in Bangladesh: Gap between policy and policy interpretation among policymakers and healthcare workersRupali J. Limaye, Berhaun Fesshaye, Prachi Singh, Eleonor Zavala, Shirina Akter, Towfida Jahan Siddiqua, Hafizur Rahman, Hasmot Ali, Ruth A. Karron2023Journal articleEnglish
Future GBS vaccines: Perspectives from pregnant and lactating people, healthcare providers, community members, and policymakers in KenyaBerhaun Fesshaye, Prachi Singh, Molly Sauer, Ruth A. Karron, Rupali J. Limaye2023Poster/infographicEnglish
Lack of clear national policy guidance on COVID-19 vaccines influences behaviors in pregnant and lactating women in KenyaEleonor Zavala, Berhaun Fesshaye, Clarice Lee, Stephen Mutwiwa, Wincate Njagi, Paul Munyao, Rosemary Njogu, Rachel Gur-Arie, Alicia M. Paul, Taylor A. Holroyd, Prachi Singh, Ruth A. Karron, Rupali J. Limaye2022Journal articleEnglish
Lessons learned from COVID-19 vaccine acceptance among pregnant and lactating women from two districts in Kenya to inform demand generation efforts for future maternal RSV vaccinesRupali J. Limaye, Prachi Singh, Berhaun Fesshaye, Ruth A. Karron2024Journal articleEnglish
Maternal Immunization Readiness Initiative (MIRI) Kenya Results DisseminationRupali J. Limaye, Berhaun Fesshaye, Prachi Singh, Emily Miller, Ruth A. Karron2023Poster/infographicEnglish
Maternal Immunization Readiness Initiative (MIRI) Kenya Results Dissemination Day 1 SlidesRupali J. Limaye, Prachi Singh, Berhaun Fesshaye, Eleonor Zavala, Clarice Lee, Ruth A. Karron2023PresentationEnglish
Maternal Immunization Readiness Initiative (MIRI) Kenya Results Dissemination Day 2 SlidesRupali J. Limaye, Prachi Singh, Berhaun Fesshaye, Eleonor Zavala, Clarice Lee, Ruth A. Karron2023PresentationEnglish
Maternal Immunization Readiness Initiative (MIRI) Kenya Results Dissemination Day 3 SlidesRupali J. Limaye, Prachi Singh, Berhaun Fesshaye, Eleonor Zavala, Clarice Lee, Ruth A. Karron2023PresentationEnglish
RSV awareness, risk perception, causes, and terms: Perspectives of pregnant and lactating women in Kenya to inform demand generation efforts for maternal RSV vaccinesRupali J. Limaye, Berhaun Fesshaye, Prachi Singh, Ruth A. Karron2023Journal articleEnglish
Sources of COVID-19 Vaccine Promotion for Pregnant and Lactating Women in BangladeshBerhaun Fesshaye, Sydney A. Wade, Clarice Lee, Prachi Singh, Eleonor Zavala, Hasmot Ali, Hafizur Rahman, Towfida Jahan Siddiqua, Shirina Akter, Ruth A. Karron, Rupali J. Limaye2023Journal articleEnglish