BMJ Open (Sep 2022)

Psychological and situational factors associated with COVID-19 vaccine intention among postpartum women in Pakistan: a cross-sectional study

  • Nicole Letourneau,
  • Ayesha Mian,
  • Imtiaz Jehan,
  • Geoffrey Omuse,
  • Shahirose Sadrudin Premji,
  • Sikolia Wanyonyi,
  • Sidrah Nausheen,
  • Naureen Akber Ali,
  • Christine Dunkel Schetter,
  • Sahar Khademi,
  • Ntonghanwah Forcheh,
  • Sharifa Lalani,
  • Kiran Shaikh,
  • Arshia Javed,
  • Erum Saleem,
  • Neelofur Babar,
  • Qamarunissa Muhabat,
  • Nigar Jabeen,
  • Shahnaz Shahid Ali,
  • Saher Aijaz,
  • Aliyah Dosani,
  • Fazila Faisal,
  • Farooq Ghani,
  • Fouzia Hashmani,
  • Nasreen Ishtiaq,
  • Rabia Khoja,
  • Heeramani Lohana,
  • Mohamoud Merali,
  • Joseph Wangira Musana,
  • Suneeta Namdave,
  • Christopher T. Naugler,
  • Christine Okoko,
  • Almina Pardhan,
  • Pauline Samia,
  • Nazia Shamim,
  • Sana Asif Siddiqui,
  • Salima Sulaiman,
  • Afia Tariq,
  • Ilona S Yim

DOI
https://doi.org/10.1136/bmjopen-2022-063469
Journal volume & issue
Vol. 12, no. 9

Abstract

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Objectives Contributing factors to COVID-19 vaccination intention in low-income and middle-income countries have received little attention. This study examined COVID-19-related anxiety and obsessive thoughts and situational factors associated with Pakistani postpartum women’s intention to get COVID-19 vaccination.Design Cross-sectional study administering a survey by a telephone interview format between 15 July and 10 September 2020.Setting Four centres of Aga Khan Hospital for Women and Children—Garden, Kharadar, Karimabad and Hyderabad—in Sindh Province, Pakistan.Participants Women who were enrolled in our longitudinal Pakistani cohort study were approached (n=1395), and 990 women (71%) participated in the survey, of which 941 women who were in their postpartum period were included in the final analysis.Primary outcome measure and factors COVID-19 vaccine intention, sociodemographic and COVID-19-related factors, Coronavirus anxiety, obsession with COVID-19 and work and social adjustment were assessed. Multiple multinomial logistic regression analysis was used to identify factors associated with women’s intentions.Results Most women would accept a COVID-19 vaccine for themselves (66.7%). Only 24.4% of women were undecided about vaccination against COVID-19, and a small number of women rejected the COVID-19 vaccine (8.8%). Women with primary education were less likely to take a COVID-19 vaccine willingly than those with higher education. COVID-19 vaccine uncertainty and refusal were predicted by having no experience of COVID-19 infection, childbirth during the pandemic, having no symptoms of Coronavirus anxiety and obsession with COVID-19. Predictors for women’s intention to vaccinate themselves and their children against COVID-19 were similar.Conclusion Understanding the factors shaping women’s intention to vaccinate themselves or their children would enable evidence-based strategies by healthcare providers to enhance the uptake of the COVID-19 vaccine and achieve herd immunity against Coronavirus.