Adapting the WHO Behavioural and Social Drivers of Vaccination (BeSD) tools and Vaccination Attitudes Examination (VAX) scale for pregnant women in South Africa: Insights from a mixed-methods pilot study

This pilot study demonstrated that the WHO BeSD tools, the VAX Scale, the General Vaccine Attitude Survey, and the questions on knowledge of influenza and attitudes toward influenza vaccination during pregnancy, with minor adaptations, are feasible and acceptable for use in South Africa. These findings support their application in larger studies to explore maternal vaccine confidence and decision-making. Addressing knowledge gaps and leveraging trusted sources of information is critical to enhancing vaccine uptake in similar settings.