COVID-19 Guidelines Adherence and Vaccine Acceptability Among Pregnant Women in Niger Foundation Hospital Enugu, South-Eastern Nigeria: A Mixed Method Study

Objectives: This study aimed to determine the acceptability of coronavirus disease 2019 (COVID-19) vaccines and adherence to the preventive protocol among pregnant antenatal attendees in Niger Foundations Hospital Enugu, South-Eastern Nigeria.Materials and Methods: Using a cross-sectional descriptive survey and in-depth interviews, we conducted a mixed method study from June to December 2021. We administered a structured questionnaire to 210 pregnant women to assess their knowledge and adherence to COVID-19 guidelines and interviewed 25 individuals. Quantitative and qualitative data were analyzed using SPSS v.28 and thematic analysis, respectively.Results: The participants' age range was 20-43 years, with a mean of 29.9 (4.8) years. Most individuals (81.9%) had a university degree, 40.5% were skilled workers, and 73.3% had parity 0-1. They identified close contact (87.1%), respiratory distress (96.2%), and handwashing with soap (96.2%) as the commonest mode of transmission, symptom, and preventive strategy of COVID-19, respectively. Older women and individuals with higher parity had lower knowledge and adherence to COVID-19 precautions. Most participants rejected the vaccines due to fear of the side effects on themselves and the fetus.Conclusions: Although there was good adherence to COVID-19 protocols among the pregnant women in this study, vaccine acceptance/uptake rate was low. Education on vaccine advantages and correction of conspiracy theories are recommended.