Data checklist.

COVID-19 has caused about 580 million cases and 6.4 million deaths worldwide by August 8th, 2022, including 8.7 million cases (173,063 deaths) in Africa. East Africa reported 1.39 million cases on July, 2022. Tanzania confirmed 37,865 cases and 841 deaths by 8th August 2022. Although billions of vaccine doses administered globally, just 17.6% of Tanzanians are fully vaccinated. Symptomatic pregnant women face a mortality risk that is 70% higher than in non-pregnant women.. Therefore, this study aimed at assessing knowledge, attitude, and acceptance of COVID-19 vaccine among pregnant women in the Mbeya region. A descriptive cross-sectional study was conducted in the Obstetrics and Gynecology department of MZRH. Three scores were calculated for participants’ knowledge, attitude, and acceptance to COVID-19 vaccination. These scores were compared to many sample factors using binary logistic regression and the chi-square test. The study recruited 233 participants. Most participants (31.3%) relied on social media for Covid-19 vaccine information. Poor Covid-19 vaccine knowledge (71.2%), negative attitudes (76.8%), and low acceptance rate (38.6%) were observed. Multivariate analysis showed that greater acceptance was positively associated with having a chronic illness (AOR = 3.21, CI 1.448-7.123, P = 0.004), stronger vaccine attitudes (AOR = 1.26, CI 1.149-1.368, P = 0.015), better vaccine knowledge (AOR = 2.70, CI 2.587-2.810, P = 0.005), and prior vaccination history (AOR = 0.13, CI 0.068-0.183, P = 0.000). Conversely, preference for natural immunity (AOR = 0.42, CI 0.341-0.498, P = 0.018), and not yet being vaccinated (AOR = 0.67, CI 0.594-0.755, P = 0.000) were all linked to lower acceptance. Pregnant women exhibited low knowledge, attitude, and acceptance to COVID-19 vaccines. Misinformation about the COVID-19 vaccine causes pause. Education on COVID-19 vaccination is needed to enhance vaccine uptake among pregnant women. This group must comprehend COVID-19 immunization importance, safety, and efficacy.