Lack of clear national policy guidance on COVID-19 vaccines influences behaviors in pregnant and lactating women in Kenya

Eleonor Zavala, Berhaun Fesshaye, Clarice Lee, Stephen Mutwiwa, Wincate Njagi, Paul Munyao, Rosemary Njogu, Rachel Gur-Arie, Alicia M. Paul, Taylor A. Holroyd, Prachi Singh, Ruth A. Karron, Rupali J. Limaye

Research output: Contribution to journalArticlepeer-review

Abstract

SARS-CoV-2 infection in pregnancy is associated with a greater risk of maternal and newborn morbidity and maternal death. In Kenya, pregnant and lactating women (PLW) were ineligible to receive COVID-19 vaccines until August 2021. How shifts in policy influence vaccine behaviors, such as health worker recommendations and vaccine uptake, is not well documented. We conducted qualitative interviews with PLW, health workers, and policymakers in Kenya to understand how different stakeholders’ perceptions of national policy regarding COVID-19 vaccination in pregnancy shaped vaccine behaviors and decision-making. Policymakers and health workers described pervasive uncertainty and lack of communication about the national policy, cited vaccine safety as their primary concern for administering COVID-19 vaccines to PLW, and expressed that PLW were inadequately prioritized in the COVID-19 vaccine program. PLW perceived the restrictive policy as indicative of a safety risk, resulting in vaccine hesitancy and potentially exacerbated inequities in vaccine access. These findings support the need for the development and dissemination of effective vaccine communication guidelines and the prioritization of PLW in COVID-19 vaccination policies and campaigns. To ensure PLW do not face the same inequities in future epidemics, data on infectious disease burdens and vaccine uptake should be collected systematically among pregnant women, and PLW should be included in future vaccine trials.

Original languageEnglish (US)
Article number2127561
JournalHuman Vaccines and Immunotherapeutics
Volume18
Issue number6
DOIs
StatePublished - 2022

Keywords

  • COVID-19 vaccine
  • Kenya
  • Maternal immunization
  • health policy
  • qualitative
  • vaccine behavior

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pharmacology
  • Immunology

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