COVID-19 Vaccine Acceptance Among Pregnant Women in Hospital Universiti Sains Malaysia
Authors: Zaid Siti Nur Aisyah , Embong Hasni , Mohd Zain Norhasmah 
Published: November 2022

Many reports recently showed the worried outcomes such as neonatal pneumonia, preterm birth, postpartum infections to the mother, and COVID-19 vertical transmission to the foetus happened in pregnancy [1,5-6]. COVID-19 vaccination is an effective and safe approach to controlling the pandemic and decreasing associated morbidity and mortality [2]. Pregnant women are more likely develop more severe symptoms of COVID-19 than their non-pregnant peers [3]. Also, there is still less study conducted in Malaysia to assess COVID-19 vaccine acceptance among pregnant women.

This cross-sectional study aimed to determine the COVID-19 vaccine acceptance rate among pregnant women in Hospital USM. Initially, 367 respondents estimated using Raosoft Software but only 254 were recruited using simple random sampling method. The link of the questionnaire was given through a WhatsApp platform. The questionnaire used were adapted from Goncu Ayhan [4] consists of three parts: sociodemographic data, acceptance rates of COVID-19 vaccine and the reasons for refusing the COVID-19 vaccine. The questionnaire was translated to Bahasa Malaysia, checked by the Language Unit USM, and validated by the experts, three nursing lecturers. The Cronbach Alpha result from the pilot test was 0.744. The data were analysed using IBM SPSS system version 26.0 and the significant level (α value) was set at 5% for all statistical analyses. All null hypotheses will be rejected if (p<0.05). The Descriptive Analysis test and the Pearson Chi-Square test were used to analyse the data. Both Human Research Ethics Committee USM and Obstetrics & Gynaecology Department in Hospital USM have approved this study. No conflict of interest in the study.

A total of 254 pregnant women, most of them being 198 were aged 20 to 35, 246 were Malays, 180 respondents with college/university education, and 110 housewives. The 68 prevalence of participants' household incomes ranged from RM1000 to RM1999 and RM4000-RM4999, and their gravida and parity are primarily at 2-3 times, with the majority occurring between 20 and 30 weeks of gestation (Table 1). This study included only 58 pregnant women who had comorbidities during their pregnancy. The results revealed pregnant women in Hospital USM had moderate acceptance of COVID-19 (M=70.00, SD=14.629) with a minimal percentage of 55% and a maximal percentage of 82%. It was revealed that 174 (68.5%) showed moderate acceptance while 42 (16.5%) showed high acceptance. Meanwhile, only 38 (15%) indicate low acceptance of the COVID-19 vaccine.

The main reasons for them to refuse the vaccine were lack of data on the safety of the COVID-19 vaccination in pregnant women, they believed that if they are sick, both mother and baby will not encounter any negative effects, and some of the family members were hesitant to be vaccinated. This study also examined the correlation between the COVID-19 vaccine acceptance rate and sociodemographic factors using Pearson's Chi- Square test. There was a significant correlation between age, educational level, career, household income, gravida, and parity with the COVID-19 vaccine acceptance rates (p<0.05). Yet, there was no significant correlation between ethnicity, gestational age, or comorbidities with the acceptance rate of the COVID-19 vaccine.

In conclusion, the acceptance rate of the COVID-19 vaccine among pregnant women needs to be increased to reduce the risk of worse complications if contracting the COVID-19 disease. Health education regarding the importance of the COVID-19 vaccine can be delivered during every antenatal visit. Since this study was conducted in hospital settings which include clinics, the pregnant women shall be familiar with the updated regulations of the health systems. This benefits the nurses to increase their efforts for pregnant women to accept those two doses followed by taking the booster willingly. If this succeeds, the risk of them contracting the coronavirus disease and getting complications from it will be eliminated.