COVID-19 Vaccine Hesitancy Among Pregnant Women in Pakistan: A Cross-Sectional Survey

COVID-19 poses heightened risks to pregnant women, yet vaccine hesitancy undermines herd immunity. This cross-sectional study assessed the prevalence, severity, and determinants of COVID-19 vaccine hesitancy among pregnant women in Pakistan and compared them with non-pregnant women. From November 2021 to February 2022, 372 pregnant and 353 non-pregnant women completed the validated 12-item Vaccination Attitudes Examination (VAX) scale and answered additional items on beliefs and intentions regarding COVID-19 vaccination. Pregnant women showed significantly higher hesitancy and higher median VAX scores across all subscales than non-pregnant women. Social media rumors, lack of fear of COVID-19, disbelief in SARS-CoV-2, and disbelief in vaccines were independently associated with hesitancy among pregnant participants. Findings highlight the urgent need for targeted strategies to improve COVID-19 vaccine uptake among pregnant women in Pakistan, including countering misinformation and strengthening trust in vaccines.