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. Author manuscript; available in PMC: 2019 Oct 1.
Published in final edited form as: Vaccine. 2019 May 6;37(25):3267–3277. doi: 10.1016/j.vaccine.2019.04.075

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)