Pregnant Women's Awareness, Perception, and Acceptability of the COVID-19 Vaccine Attending Antenatal Clinics in Bharatpur, Nepal, 2022

The COVID-19 vaccine is a cost-effective and reliable public health intervention to combat the emerging COVID-19 pandemic. The vaccination is considered safe and effective at any stage of pregnancy; however, pregnant women show more vaccine hesitation than the general population. This study aims to assess pregnant women's awareness, perception, and acceptability of the COVID-19 vaccine attending antenatal clinics. An institutional-based cross-sectional analytical study design was used to assess the acceptance of the COVID-19 vaccine and associated factors among pregnant women between Feb-1 to March-30 -2022 at antenatal clinics of Bharatpur Chitwan using systematic random sampling. A semi-structured interview schedule was used to collect data from 644 respondents. Collected data were analyzed using descriptive and inferential statistics like the Pearson chi-square test and logistic regression analysis. The COVID-19 vaccine acceptance was found to be 22 % and ethnicity (AOR =1.826; 95% CI = 1.215-2.745) , education level (AOR=1.773; 95%CI= 1.025-3,068; ), history of COVID-19 infection (AOR =3.63 ;95% CI=1.323-9.956;) ,number of child (AOR= 5.021; 95% CI 1.989-12.677; ), trimester (week of pregnancy) (AOR=2.437; 95% CI 1.107-5.366 ) and level of perception (AOR= 2.152; 95% CI 1.109-4.178) were found to be statistically significant for acceptance of COVID-19 vaccine among pregnant mother. In this study, low levels of vaccine acceptance were found. Several influential factors like occupation, history of COVID-19 infection, number of pregnancies, week of gestation, and level of attitude were found to be significant for acceptance of the COVID-19 vaccine among pregnant women. Everyone needs vaccine acceptance to get herd immunity and reduce the COVID-19 infection. But Vaccine hesitancy is one of the significant threats to the COVID-19 rollout and successful pandemic mitigation. Therefore, properly disseminating information and removing misperceptions about the COVID-19 vaccine is necessary to raise the acceptance.

COVID-19疫苗是应对新发COVID-19大流行的一种具成本效益且可靠的公共卫生干预措施（public health intervention）。孕期各阶段接种该疫苗均被认为是安全有效的；然而，孕妇的疫苗犹豫（vaccine hesitation）程度高于普通人群。

本研究旨在评估就诊于产前诊所（antenatal clinics）的孕妇对COVID-19疫苗的认知、看法及接受度。本研究采用机构性横断面分析研究（institutional-based cross-sectional analytical study）设计，于2022年2月1日至3月30日期间，在奇旺市 Bharatpur 的产前诊所中通过系统随机抽样（systematic random sampling）方法，评估孕妇对COVID-19疫苗的接受度及其相关因素。研究采用半结构化访谈表（semi-structured interview schedule）收集了644名受访者的数据。

收集的数据采用描述性与推断性统计（descriptive and inferential statistics）方法进行分析，包括皮尔逊卡方检验（Pearson chi-square test）及逻辑回归分析（logistic regression analysis）。研究发现，孕妇对COVID-19疫苗的接受率为22%；且族群（调整后优势比，Adjusted Odds Ratio [AOR]=1.826，95%置信区间，Confidence Interval [CI]=1.215-2.745）、教育水平（AOR=1.773，95%CI=1.025-3.068）、COVID-19感染史（AOR=3.63，95%CI=1.323-9.956）、子女数量（AOR=5.021，95%CI=1.989-12.677）、孕期阶段（孕周，AOR=2.437，95%CI=1.107-5.366）及认知水平（AOR=2.152，95%CI=1.109-4.178）是影响孕妇接受COVID-19疫苗的统计学显著因素。

本研究中观察到疫苗接受率较低。职业、COVID-19感染史、妊娠次数、孕周及态度水平等多项因素被发现对孕妇接受COVID-19疫苗具有显著影响。

为获得群体免疫（herd immunity）并降低COVID-19感染率，需提升大众对疫苗的接受度。然而，疫苗犹豫是COVID-19疫苗推广及大流行成功缓解的重大威胁之一。

因此，需通过合理传播信息及消除对COVID-19疫苗的误解，以提升疫苗接受率。