Despite the availability of the coronavirus disease 2019 (COVID-19) vaccination, uptake among pregnant women in Sub-Saharan Africa has been low. This scoping review aimed to identify and characterize determinants influencing COVID-19 vaccination decision-making behaviors among pregnant women in Sub-Saharan Africa. We searched five online databases for articles on COVID-19 vaccination among pregnant women in Sub-Saharan Africa. We identified studies published in English between March 2020 and April 2023 that assessed vaccine-specific issues, psychosocial constructs, and contextual factors associated with COVID-19 vaccination decision-making behaviors. Of the fourteen studies identified, over half (57.1%) were cross-sectional; three used qualitative research methods; and three involved multi-country participants. Most studies assessed COVID-19 vaccination acceptability and willingness. Overall, 85.7% of the publications examined knowledge, attitudes, or both as critical factors associated with COVID-19 vaccination. The prevalence of COVID-19 vaccine uptake during pregnancy was low in Sub-Saharan Africa (14.4–28%). While most current studies assess COVID-19 vaccination knowledge, research on maternal vaccination in Sub-Saharan Africa would benefit from the inclusion of theory-informed and driven studies that measure additional psychosocial factors and contextual constructs. Future studies should also employ study designs that can determine causal pathways of vaccination determinants and vaccination uptake.

COVID-19 vaccination during pregnancy has been recommended, but the perceptions related to uptake remain unexplored. This pilot study aimed to explore how perceptions influence COVID-19 vaccine uptake among a sample of 115 pregnant women in Kenya, recruited via WhatsApp. Data were collected using an adapted online questionnaire between May and October 2022. Logistic analyses assessed the relationship between COVID-19 vaccination uptake and the Theory of Reasoned Action (TRA) constructs: attitudes and subjective norms. COVID-19 vaccination coverage was 73%, with vaccine hesitancy estimated at 41.4% among the unvaccinated group. Most participants had completed college education and had good knowledge of COVID-19 vaccines. There was no significant effect of enrollment in WhatsApp pregnancy groups on attitudes toward COVID-19 vaccination. Pregnant women were concerned about vaccine effectiveness (31.1%), and almost one-half (47.3%) were discouraged from receiving COVID-19 vaccines. Positive attitudes towards vaccination were associated with COVID-19 vaccination (aOR 2.81; 95% CI 1.12–7.04; p = 0.027), but no significant relationship was found between COVID-19 vaccination and strong subjective norms (influences to get COVID-19 vaccines). Our findings suggest that strategies to improve vaccination should consider targeting attitudes and proximal social networks (friends/family) to facilitate vaccination decision-making. WhatsApp can be used for research distribution and enhance the dissemination of accurate information.

The 9-valent human papillomavirus (9-vHPV) vaccine uptake rate among adolescents has improved over the years; however, little is known about the adherence to the recommended dosing schedule. This study examines the prevalence and factors associated with adherence to the recommended 9vHPV vaccination dosing schedule among adolescents aged 13 to 17 years. The cross-sectional study was conducted using the 2019–2020 National Immunization Survey-Teen. The parents of 34,619 adolescents were included in our analyses. The overall up-to-date (UTD) prevalence was 57.1%. The UTD prevalence was 60.0% among females and 54.2% among males. Adolescents aged 16 years had the highest UTD prevalence of 63.0%. The UTD prevalence was 61.6% among Hispanics and 54.7% among non-Hispanic Whites. Overall, compared to females, males had 14% lower odds of UTD. The odds of UTD were 1.91 times, 2.08 times, and 1.98 times higher among adolescents aged 15–17 years, respectively, compared to those aged 13 years. Moreover, region, poverty, insurance status, mothers’ educational level, and provider recommendation were associated with UTD. Our findings show that adherence to the recommended 9vHPV vaccine schedule is low in the US. Targeted public health efforts are needed to improve the rates of adherence to the recommended 9vHPV dose schedule.

Resilience, the successful process of growth and adaptation in the face of adversity, stress, or trauma, is crucial for optimal well-being. During the COVID-19 pandemic, Latino day laborers (LDLs) faced multiple stressors, making them vulnerable to poor mental health outcomes. Using a cross-sectional study design, we examine the association between situational stressors, mental health, and resilience among LDLs during the COVID-19 pandemic. Data included sociodemographic information and measures of situational stressors, mental health (depression, anxiety, and stress), and resilience. Positive and negative resilience subscales were analyzed separately due to a high correlation. A total of 300 male participants completed the surveys, with a mean age of 45.1 years. Almost half had never been married (48%) and had completed nearly eight years of school. The results indicated no significant associations between stressors, positive resilience, and mental health outcomes (B = 0.023, NS) but a significant association between negative resilience, mental health outcomes, and some stressors, such as lack of money (B = 0.103; p < 0.05). The implications of this study include the need to further investigate the use of negatively worded items and how resilience is demonstrated among other vulnerable populations or cultural groups.

Pregnant women, considered at risk of COVID-19 complications because of the immunosuppressive and physiological changes in pregnancy, were initially hesitant to receive COVID-19 vaccination. This study assessed the association between COVID-19 vaccination uptake, psychological determinants (health belief model (HBM) constructs, anticipated regret, trust in health authorities), and provider recommendation among pregnant women in Kenya. Using data from a cross-sectional study, we conducted correlations, binary and multivariable logistic regressions, and moderation analysis to explore relationships between COVID-19 vaccination and psychological variables. Of the 115 pregnant women, 64% reported receiving provider recommendations for COVID-19 vaccination. There were weak positive correlations between the variables. Participants with high anticipated regret scores were more likely to receive COVID-19 vaccination compared to their peers (AOR = 4.27; 95% CI, 1.23–14.85), while provider recommendation increased the odds of COVID-19 vaccination (OR = 3.70; 95% CI, 1.53–8.92). None of the HBM constructs were significantly associated with COVID-19 vaccination. The findings related to psychological variables require the reconceptualization of theory-informed interventions to streamline healthcare provision. The critical role of healthcare providers in COVID-19 vaccination recommendations suggests a need to empower health practitioners with effective communication skills to improve maternal health outcomes.

The high rates of adolescent pregnancy in Kenya are due, in part, to the lack of discussions about sexual and reproductive health (SRH) between children and their parents/guardians. The aim of this study was to assess the association between parent-child communication and SRH outcomes among youth in western Kenya. Cross-sectional data was collected in September 2022 from 1,598 youth (ages 15-24) who completed a survey about parent- child communication and SRH behaviors. Using descriptive statisticsand logistic regressions, we assessed the association between parent-child communication and three SRH outcomes: intention to abstain from sex, use of family planning methods, and consistent condom use. Results showed that the intention to abstain from sex was high among all study participants (65 %). Among those with prior sexual experience, the use of family planning methods was high (68 %), while consistent condom use was low (39 %). Parent-child communication about SRH was low, with a mean score of 5.5 out of 14.Findings indicated significant positive associations between parent-child communication and intention to abstain for at least one year (AOR= 1.07; 95 % CI: 1.05-1.10), and consistent condom use (AOR = 1.08; 95 % CI: 1.03-1.12), although the use family planning methods among females was not statistically significant. Parents do not frequently discuss sexual topics with their children.While there were differences in rates of intention to abstain by gender, parent-child communication was significant.There is a need to equip parents and youth with SRH discussion skills toimprove SRH outcomes among adolescents.