2. Review methods
2.1 Protocol and registration
2.2 Search strategy and study selection
2.3 Search outcome
|Author name,year||Country||Sample size||Study's design||Age in years||Education > (HS)||Inclusion criteria||Studies outcome|
|Multi center survey||33 (median)||721||Pregnant women or lactation mother(0–12 weeks) at least 18 years and above age at time data collection||After the first pandemic wave, Switzerland had a low SARS-CoV-2 vaccination acceptance rate, emphasizing the need to identify and reduce barriers for immunization in pregnant and breastfeeding women, particularly among the youngest and those with a lower educational level|
|Nguyen et al., 2021||Vietnam||P-651||CS||29.4 ± 5.4||403||Age above 18 years of Pregnant women or just given birth.||Implementing COVID- 19 vaccination and resource mobilization among pregnant women in Vietnam is feasible, although communication programs to improve risk perception and awareness about vaccine should be developed for facilitating acceptance of the vaccine|
|Skjefte et al., 2021||USA||5282||CS||<35= 4156|
>35 = 1125
|4565||Women currently pregnant or with at least one child under 18 years of age||About 52% of pregnant women ready to take COVID-19 vaccine, when efficacy more than 90%.Prediction of vaccine acceptance different vary globally. However vaccine acceptance among women and children should be specific for each country in order to attain the largest impact.|
|Goncu et al., 2021||Turkey||300||CS||27.99 ± 5.6||72||Pregnant mother who were attending prenatal care centers.||About 37% (111) pregnant women ready o take COVID vaccine. Lack of knowledge on COVID-19, concern to fetal harm were major reason for vaccine rejection in pregnancy population.|
|Hoque et al., 2020||South Africa||346||CS||26.7 ± 6.81||45||Pregnant women attending antenatal clinic during COVID pandemic||The rate of COVID vaccine acceptance higher among younger pregnant women (93%).Similarly 75.3% of pregnancy women who had one or two children likely to accept COVID vaccine.|
|Hailemariam et al., 2021||Ethiopia||412||CS||30.6 ± 5.9||159||Pregnant women more than 18 years residing at least 6 months in the area.||Approximately 217 (52.6%) pregnant women positive perception towards COVID vaccine. Participants with good knowledge likely receive three times COVID vaccine.|
|Ceulemans et al., 2021||IE,|
NO, CH, NL &UK
>35 = 4375
|10,688||Age >18 years of pregnant & lactation mother(0–3 months)||First trimester women and lactation mother more likely received the COVID vaccine. Low family income and health care workers are less interested to receive COVID vaccine|
|Tao et al., 2021||China||1392||Multi center CS||<35=1231|
>35 = 161
|1154||Pregnant >18 years those attending antenatal clinic||Overall 77.4% of participants were intended to take COVID vaccine. In contract age inversely proportional to COVID vaccine acceptance among pregnant women.|
|Desmond Sutton et al., 2021||USA||T-338|
|CS||P-34 ± 6|
BF-35 ± 7
|NR||Pregnant women and breast feeding mothers those.||Overall 656 participants, 318 (64.8%) were non pregnant, 216 (21.3%) were pregnant, and 122 (12.1%) were breastfeeding. Pregnant women likely accept COVID vaccine ((76.2%), breast feeding mother (55.2%).and pregnant women (44.3%).Working with care center was not influence the vaccine acceptance.|
|Sznajder et al., 2022||USA||196||Multi center CS||<35=157|
>35 = 39
|The pregnant women age >18 years||Education and history of Influenza vaccine increases COVID vaccine acceptance among pregnant women. Timely health teaching will improve future pandemic responses and current vaccination efforts.|
|Mappa et al., 2021||Italy||161||CS||33|
|156||Pregnant women visit antenatal care in last 2 weeks||About 136 (84.5%) pregnant women in favor to COVID vaccine. Education and unemployment inversely propositional to COVID vaccine.|
|Mohan et al., 2021||Qatar||341||CS||30||NR||Pregnant and breast feeding mothers||Approximately 75% of participants disinterest in COVID vaccine. Further 18.3% participants were not recommending COVID vaccine to their family.|
|Skirrow et al., 2022||UK||T-1181|
|Multi center survey||<35=461|
>35 = 720
|NR||Residents in UK and over 16 years||About (62.1%) of pregnancy women are willing to accept COVID vaccine. Standard intervention required to justify the efficacy of COVID vaccine.|
|Riad et al., 2021||Europe||T-362|
|CS||>31 = 183|
<31 = 172
|Pregnant or lactation women (last 6 months of delivery) age 15–44 years.||About pregnancy (76.6%) and lactating (48.8%) women ready to take COVID vaccine. Although overall 70.2% participants in favor immediate and delayed vaccination.|
|Egloff et al., 2022||France||664||Multi center Survey||>35 = 32|
<35 = 132
|522||All pregnant women attending French obstructive department.||Of the 664 participants, 29.5% of pregnancy women willing to accept COVID vaccine. Following reasons for accepting COVID vaccine to protect themselves (84.7%), to protect relations (79.6%) or to protect the newborn (62.2%).The reason for vaccine avoidance about (76.9 fear to fetal and (33.8%) themselves transmission.|
|Kumari et al., 2022||India||313||CS||28.32 ± 4.62||256||All pregnant women attending in-patient and out patients department||The future effect on fetus was a major reason for vaccine unacceptance (58.6%) among pregnant women. The safety was major concern for hesitancy of COVID vaccine.|
|Carbone et al., 2020||Italia||142||Multi centers survey||34||21||Pregnant women attending outpatient department and post-operative women||The majority of pregnant women and lactating mother not willing to take COVID vaccine. Further there were no significance between COVID acceptance and marital status, employment, marital status, pregnancy etc.|
|Desai, 2021||India||124||CS||29.9 ± 2.89||61||Pregnancy women older than 18 years,||Participants who received annual Influenza vaccine more likely receive COVID 19 vaccine.|
|Geoghegan et al., 2021||Ireland||300||CS||<35=131|
>35 = 56
|163||Pregnant women||About 113(38%) of pregnant women are score >8, as they likely take COVID vaccine in concern of their unborn fetus.|
|Kiefer et al., 2022||USA||456||CS||29.3 ± 5.38||324||Pregnant women and post-operative women||About 46% vaccine participants were not willing to take COVID vaccine. Barrier of government services major reason for COVID vaccine hesitancy among pregnant women.|
|Mose & Yeshaneh, 2021||Ethiopia||396||Multi center survey||<35=354|
>35 = 42
|82||All pregnant women visit antenatal care follow-up||There was 70.7% of pregnant willingness COVID vaccine. Education, knowledge and good practice are major factors for acceptance.|
|Battarbee et al., 2022||USA||915||Multi center survey||<35=741|
>35 = 172
|591||Participants age from 18 to 50 years old and were at less than 28 weeks gestation.||Only 41% of participants were ready to take COVID vaccine. About 72% worried to sick if take COVID vaccine, Although most pregnant women worried about COVID-19 illness, <50% were willing to get vaccinated during pregnancy.|
|Levy et al., 2021||USA||662||CS||<35=415|
>35 = 237
|565||Participants above >18 years||About 381/653 (58.3%) of pregnant women in favor to COVID vaccine. The risk of fetal transmission (45.8%) and side effects45.8%) were major reason for vaccine rejection among pregnant women.|
|Hosokawa et al., 2022||Japan||1621||Multi center survey||<35=1206|
>35 = 415
|1369||Pregnant women||The prevalence of vaccination and vaccine hesitancy among pregnant women was 13.4% (n = 217) and 50.9% (n = 825), respectively. Adverse effect and fetal side effects were major concerns.Vaccine hesitancy was significantly associated with the lack of trust in the government.|
2.4 Quality evaluation
|Author||Sample size >200||Representativeness of samples >70%||Response rate|
|Valid tool||Not required further statistical calculations||Study quality|
|Nguyen et al., 2021||*||*||*||*||*||Low risk|
|Skjefte et al., 2021||*||*||*||*||*||Low risk|
|Goncu et al., 2021||*||*||*||*||*||Low risk|
|Hoque et al., 2020||*||*||*||*||*||Low risk|
|Hailemariam et al., 2021||*||*||*||*||*||Low risk|
|Ceulemans et al., 2021||*||*||*||*||*||Low risk|
|Tao et al., 2021||*||*||*||*||*||Low risk|
|Desmond et al., 2021||*||*||*||*||*||Low risk|
|Sznajder et al., 2022||*||*||*||*||*||Low risk|
|Mappa et al., 2021||*||*||*||*||*||Low risk|
|Mohan et al., 2021||*||*||*||*||*||Low risk|
|Skirrow et al., 2022||*||*||*||*||*||Low risk|
|Riad et al., 2021||*||*||*||*||*||Low risk|
|Egloff et al., 2022||*||*||*||*||*||Low risk|
|Kumari et al., 2022||*||*||*||*||*||Low risk|
|Carbone et al., 2020||*||*||*||*||*||Low risk|
|Desai, 2021||–||*||*||*||*||Low risk|
|Geoghegan et al., 2021||*||*||*||*||*||Low risk|
|Kiefer et al., 2022||*||*||*||*||*||Low risk|
|Mose & Yeshaneh, 2021||*||*||*||*||*||Low risk|
|Battarbee et al., 2022||*||*||*||*||*||Low risk|
|Levy et al., 2021||*||*||*||*||*||Low risk|
|Hosokawa et al., 2022||*||*||*||*||*||Low risk|
2.5 Statistical analysis
|Studies outcome||Number of studies||Samples||Prevalence(95% CI)||I2 in percentages|
|Participants' age||<35 years||24||26304||77(0.76, 0.78)||99.9|
|COVID vaccine acceptance during pregnancy||1st trimester||8||1473||14(0.13,0.15)||99.8|
|Comorbidity during pregnancy||One or more chronic disease||11||1474||21(0.20,0.22)||–|
|Literacy rate vs COVID acceptance||>High school||14||7471||64(0.55,0.73)||98.9|
|Study setting||South & North America||7||4589||48(0.47,0.49)||99.1|
|Number of children||No child||11||5165||21(0.20,0.22)||99.8|
|Acceptance of COVID vaccine among studies' participants||Pregnancy||23||12068||54(0.46,0.61)||99.2|
|History of previous vaccination influences COVID vaccine acceptance||Influenza vaccine||8||2206||67(0.53,0.80)||99.01|
- Kumari A.
- Mahey R.
- Kachhawa G.
- Kumari R.
- Bhatla N.
3.1 Demographic variables Vs COVID vaccine acceptance among pregnant women
3.2 The prevalence rate of COVID Vaccine acceptance among pregnant and laction women
- Kumari A.
- Mahey R.
- Kachhawa G.
- Kumari R.
- Bhatla N.
- Kumari A.
- Mahey R.
- Kachhawa G.
- Kumari R.
- Bhatla N.
3.3 Prevalence of COVID vaccine acceptance with a literacy level of pregnant women
- Chew N.W.S.
- Cheong C.
- Kong G.
- et al.
4.1 Strength and limitation
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