Table 4.

Some factors influencing Vaccine Hesitancy in pregnant women and measures to address barriers.

Factors influencing Vaccine Hesitancy Perceptions about the risk of the disease and disease severity Lack of recommendations by healthcare workers (HCW), government, and advisorybodies Lack of knowledge about vaccines during pregnancy Mistrust of vaccines Concerns about vaccine safety and effectiveness Fear of needles Lack of vaccines being offered by HCW, access to vaccination services, availability of vaccines and low ANC participation Payment required for the vaccine and administration costs Lack of effective communication and dissemination of recommendations from HCW, and public health bodies Societal factors like family influence, social norms, religion and lack of decision-making autonomy/ skills among pregnant women

Measures to address barriers Education by HCW (including nurses, midwives and doctors) Strong healthcare worker recommendations for vaccination, including verbal, face-to-face recommendations from a physician Risk communication developed in collaboration with key stakeholders Targeting specific groups in the community e.g. women’s-groups, community and religious leaders Positive media coverage High-quality obstetric care Acceptable and affordable immunization services offered through well-staffed clinics (including ANC clinics, community health centers, health posts, private health facilities, and hospitals), pharmacies, churches/ faith-based organizations, and other settings. Immunization services readily accessible by transportation, with convenient timings, and absence of long queues Reminders and follow-up (including automated text message reminders about vaccination)