Predictors of Uptake of Covid-19 Vaccine among Pregnant Women Utilizing Antenatal Care Services at Pumwani Maternity Hospital in Nairobi County, Kenya

Abstract

Pregnant women are at higher risk of severe outcomes from COVID-19, including hospitalization, ICU admission, invasive ventilation, and maternal mortality. Despite the critical role of vaccination in mitigating these risks, global uptake remains suboptimal. The morbidorty and mortality due COVID-19 pandemic, 548,907,839 confirmed cases and 6,350,712 deaths worldwide, while in Africa, there have been 12,294,667 cases and 255,784 deaths. In Kenya, there have been 332,227 cases and 5,652 deaths. As of May 2022, global COVID-19 vaccine uptake among pregnant women was 54%, while in Kenya, only 31% were fully vaccinated and 9.2% partially vaccinated. This study aimed to identify factors influencing COVID-19 vaccine uptake among pregnant women attending antenatal care at Pumwani Maternity Hospital in Nairobi County, Kenya. A health facility-based cross-sectional study using mixed methods was conducted among 302 pregnant women between June 19 and July 14, 2023. Participants were systematically sampled, and data were collected through face-to-face interviews using a pre-tested semi-structured questionnaire and key informant interviews. Quantitative data were analyzed using SPSS, employing descriptive statistics and logistic regression (p<0.05). The proportion of the COVID-19 vaccine uptake among participants was 41.1%. Being married was associated with lower odds of vaccination (AOR=3.65, 95% CI: 0.62–1.80), while having secondary education (AOR=3.78, 95% CI: 0.99–2.88) and being employed (AOR=2.66, 95% CI: 1.31–3.06) increased the likelihood of vaccination. Key individual-level predictors included marital status, education, and employment, while facility-level barriers included resource limitations and vaccine stockouts. The findings highlight low vaccine uptake and emphasize the need for strategies to address both individual and systemic barriers. Recommendations include improving women’s economic and educational status, integrating COVID-19 vaccination into routine maternal care, enhancing health promotion, and increasing awareness about vaccine safety during pregnancy and breastfeeding.