“Now that the baby is out, I can be vaccinated”: a qualitative study on COVID-19 vaccine hesitancy in pregnant women in Kilifi, Kenya
COVID-19 vaccines are safe and effective in pregnancy, but vaccine hesitancy limits uptake and effectiveness. This study explored COVID-19 vaccine hesitancy in pregnancy in Kilifi, coastal Kenya, to elicit reasons for vaccine hesitancy and acceptance, and to compile misconceptions around vaccination in pregnancy. Twenty-three in-depth interviews were conducted with pregnant women, mothers who had given birth in the previous 2 years and health workers (community health promoters, nurses, and supervisors). Data were analyzed using thematic template analysis based on the Vaccine Hesitancy Determinants Matrix. Concern about vaccine safety for the unborn baby was a major driver of hesitancy. Many pregnant women had limited knowledge of the potential benefits to the unborn baby, leading to postponing vaccination until after pregnancy. The initial government exclusion of pregnant women from vaccination led many to believe that vaccines were unsafe in pregnancy, long after the eligibility was revised. Aggressive promotion of the vaccine by the government was a source of mistrust and misconceptions. Integrating COVID-19 vaccination into routine antenatal care improved acceptance and development and dissemination of local guidelines boosted healthcare workers' confidence in offering vaccines to pregnant women. Future rollouts of vaccines for pregnant women should consider vaccination within antenatal care clinics alongside other routine pregnancy vaccines to enhance vaccine acceptance.
Authors
- Yorro Bah
- Liberty Cantrell (ORCID: https://orcid.org/0000-0001-5413-7641)
- Patricia Okiro
- Lazaro M. Quimice
- Hiten D. Mistry (ORCID: https://orcid.org/0000-0003-2564-7348)
- Joseph Ouma (ORCID: https://orcid.org/0000-0001-5249-7440)
- Bridget Freyne (ORCID: https://orcid.org/0000-0002-9542-1582)
- Benjamin Barratt (ORCID: https://orcid.org/0000-0002-5983-0426)
- Ursula Gazeley (ORCID: https://orcid.org/0000-0003-3309-7411)
- Baboucarr Njie
- Jeff Bone
- Judith E. Cartwright (ORCID: https://orcid.org/0000-0003-0246-9091)
- Tatiana Taylor Salisbury (ORCID: https://orcid.org/0000-0002-8249-3886)
- Rachel Tribe (ORCID: https://orcid.org/0000-0003-1769-091X)
- Stephen Cose (ORCID: https://orcid.org/0000-0002-5156-037X)
- Madeleine Cochet (ORCID: https://orcid.org/0000-0002-0436-4843)
- Robert Mboizi
- Geoffrey G. Katana (ORCID: https://orcid.org/0000-0002-3124-6615)
- Shilla Unda Dama
- Fatoumata Kongira (ORCID: https://orcid.org/0009-0007-8446-4521)
- Peter Mwangome
- Isaac G. Mwaniki (ORCID: https://orcid.org/0009-0003-1299-1657)
- Moses W. Mukhanya (ORCID: https://orcid.org/0000-0002-3954-9426)
- Onesmus Wanje (ORCID: https://orcid.org/0000-0002-0271-2533)
- Nathan Barreh
- Alice Mnyazi Kombo
- Merryn Voysey
- Anna Roca
- Joseph Mutunga
- Grace Maitha
- Emily Mwadime
- Kelly Pickerill
- Joy E. Lawn
- Kirsty Le Doare
- Lauren Hookham
- Joseph Akuze
- Liberty Makacha
- Inácio Mandomando
- Gibril Gabbidon
- Aris Papageorghiou
- Akbar K. Waljee
- Abdoulie Bah
- Brahima Diallo
- Sonia Maculuve
- Samantha Lissauer
- Yahaya Idris
- Jing (Larry) Li
- Lucilla Poston
- Modou F. S. Ndure
- Gordon Rukondo
- Juma Gumbo
- Salesio Macuacua
- Geoffrey Omuse
- Guy Whitley
- Prestige Tatenda Makanga
- Sanjeev Krishna
- Laura A. Magee
- Domena Tu
- Grace Mwashigadi
- Helena Boene
- Lawrence Gibba
- Amina Abubakar
- Peter von Dadelszen
- Melani Etti
- Victoria Nankabirwa
- Matt Silver
- Mai-Lei Woo Kinshella
- Rachel Craik
- Kalvor Sommerfelt
- Richmond Mdindi
- Thomas Mendy
- Veronique Filippi
- Sharon Konde
- Alison Noble
- Corssino Tchavana
- Hawanatu Jah
- Marie-Laure Volvert
- Robin Okello
- Reason Mlambo
- Angela Koech
- Andrew Prentice
- Esperança Sevene
- Marleen Temmerman
- Melisa Martinez-Alvarez
- Marianne Vidler
- Donna Russell
- Umberto D’Alessandro
- Carla Carillho
- Marvin Ochieng
- Sambou Suso
- Hannah Blencowe
- Kondwani Kawaza
- Anifa Vala
Institutions
- Aga Khan University (PK)
- University of British Columbia (CA)
- St George's, University of London (GB)
- King's College London (GB)
- Pwani University (KE)
- Ghent University (BE)
- Aga Khan University (TZ)
Publication Details
- Journal
- Frontiers in Public Health
- Published
- 2026-02-06
- DOI
- https://doi.org/10.3389/fpubh.2026.1730282
- Primary Topic
- COVID-19 Impact on Reproduction
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Institute for Health and Care Research