Pregnant women weigh baby safety in vaccine decisions

Infections during pregnancy can harm a developing fetus, newborn babies, and the pregnant person, yet there is limited research about how pregnant women view specific infections and the vaccines that might protect against them. Tuberculosis (TB), malaria, Group B streptococcus (GBS), and respiratory syncytial virus (RSV) are four infections known to cause negative outcomes for maternal and neonatal health. Some vaccines are already available for adults—malaria and RSV vaccines were noted as available—while TB and GBS vaccines remain in various stages of clinical trial development. To understand how pregnant women feel about these protections, Rupali J. Limaye and her team carried out a study asking pregnant women about their attitudes and intentions toward vaccines for these four infections. The researchers focused on women who were seeking care in mainly urban health facilities in Brazil, Ghana, Kenya, and Pakistan. By directly asking pregnant women about what matters to them when deciding about vaccines, the study aimed to reveal priorities and concerns that could shape future vaccine use and research.

The team used a cross-sectional survey to collect views from pregnant women seeking care in primarily urban health facilities across Brazil, Ghana, Kenya, and Pakistan. In total, 1,603 pregnant women completed the survey. When asked what influenced their decision to accept a vaccine, participants said vaccine safety for the baby was the most important factor, followed by vaccine efficacy for the baby, and then vaccine safety for the baby (as reported in the study). Asked why they would receive any of the four vaccines, most said protecting the baby was the main reason, followed by protecting themselves, and then stopping the spread of disease. Intent to receive specific vaccines varied: about 30% said they would definitely intend to receive a GBS vaccine, 26% for malaria, 25% for RSV, and 19% for TB. Measures of hesitancy were also recorded: roughly 40% agreed that vaccines are unnatural, 38% agreed the body should develop natural immunity, and 19% reported having delayed a recommended vaccine.

These findings show that pregnant women are interested in receiving vaccines during pregnancy but that their decisions are shaped strongly by concerns about the baby’s safety and how well a vaccine will protect the baby. The mix of interest in vaccination and presence of hesitancy beliefs—such as viewing vaccines as unnatural or preferring natural immunity—suggests that simply making vaccines available may not be enough to achieve high uptake. As TB and GBS vaccines move through clinical trials and as malaria and RSV vaccines are offered, understanding the priorities and worries of pregnant women is important. The researchers note that this understanding can inform clinical trial design—so studies better address the issues that matter to participants—and, over the long term, help shape communication and policy to improve vaccine acceptance among people at higher risk for these diseases.