What we did
We explored COVID-19 vaccine hesitancy during pregnancy in Kilifi, coastal Kenya, to understand reasons for vaccine acceptance and refusal and to identify common misconceptions about vaccination in pregnancy. We conducted 23 in-depth interviews with pregnant women, mothers who had delivered within the previous two years, and health workers, including community health promoters, nurses, and supervisors. The data were analyzed using thematic template analysis guided by the Vaccine Hesitancy Determinants Matrix.

What we found
Concern about vaccine safety for the unborn baby emerged as the main driver of vaccine hesitancy among pregnant women. Limited awareness of the benefits of COVID-19 vaccination for both the mother and the unborn baby led many women to delay vaccination until after pregnancy. The initial exclusion of pregnant women from vaccination by the government reinforced beliefs that vaccines were unsafe in pregnancy, even after eligibility guidelines changed. Additionally, aggressive government promotion of COVID-19 vaccines contributed to mistrust and the spread of misconceptions.

What’s next
Integrating COVID-19 vaccination into routine antenatal care services was found to improve vaccine acceptance among pregnant women. The development and dissemination of clear, locally relevant guidelines increased health workers’ confidence in recommending vaccination during pregnancy. Future vaccine rollouts targeting pregnant women should prioritize delivery through antenatal care clinics alongside other routine pregnancy vaccines to enhance trust, acceptance, and uptake.

Read our recent publication:

Koech A, Wanje O, Mwashigadi G, Katana G, Mdindi R, Mwangome P, Craik R, Vidler M, Kinshella M-LW, von Dadelszen P, Le Doare K, Temmerman M, The periCOVID-Africa Consortium and The PRECISE Network (2026) “Now that the baby is out, I can be vaccinated”: a qualitative study on COVID-19 vaccine hesitancy in pregnant women in Kilifi, Kenya.

https://doi.org/10.3389/fpubh.2026.1730282