Health workers (HWs) have a key role in promoting vaccine acceptance. This study draws on the Behavioral and Social Drivers of Vaccination (BeSD) model and our team’s investigation of vaccine hesitancy in a sample of 1197 HWs across 14 Caribbean countries in 2021. We conducted a cross-sectional Internet survey of 6718 HWs across 16 countries in Latin America in spring 2022, after the COVID-19 vaccine had recently become widely available in the region. The survey assessed HWs’ attitudes regarding COVID-19 vaccines and vaccines in general. As a proxy measure of COVID-19 vaccine acceptance, we used the willingness to recommend the COVID-19 vaccine to eligible people. Ninety-seven percent of respondents were COVID-19 vaccine acceptant. Although nearly all respondents felt that the COVID-19 vaccine was safe and effective, 59% expressed concerns about potential adverse effects. Despite uniformly high acceptance of the COVID-19 vaccine overall and across Latin American subregions, acceptance differed by sex, HW profession, and COVID-19 history. Social processes, including actions and opinions of friends, family, and colleagues; actions and opinions of religious leaders; and information seen on social networks shaped many respondents’ opinions of vaccines, and the magnitude of these effects differed across both demographic and geographic subgroups. Information campaigns designed for HWs should underscore the importance of vaccine safety. Messages should be tailored to specific audiences according to the information source each is most likely to consult and trust.

BackgroundMaternal immunization is a cornerstone to protect pregnant individuals and newborns. In Argentina, the prenatal schedule includes vaccines against influenza, COVID-19, and, since 2024, respiratory syncytial virus (RSV). This study assessed behavioural and social drivers (BeSD) of acceptance for these vaccines among pregnant individuals in Argentina.MethodsWe conducted a mixed-methods cross-sectional study in seven Argentine jurisdictions from September to November 2024. A BeSD-based interviewer-administered survey was completed by 452 pregnant individuals attending prenatal care in public and private facilities. We used descriptive analyses and logistic regression models accounting for the clustered design to examine acceptance and associated factors.ResultsIntention to vaccinate was high for influenza: 349/452 (77.2%) would receive the vaccine in the next campaign; 72 (15.9%) were unsure and 31 (6.9%) did not intend to vaccinate. During the current pregnancy, 30/452 (6.6%) reported receiving a COVID-19 dose; among those not vaccinated (422), 48 (11.4%) intended to vaccinate, 258 (61.1%) were unsure, and 116 (27.5%) did not intend to vaccinate. For RSV, 25/452 (5.5%) reported vaccination in the current pregnancy, 79 (17.5%) were unsure, and 348 (77.0%) were unvaccinated; among the latter, 158 (45.4%) intended to vaccinate, 153 (44.0%) were unsure, and 37 (10.6%) did not intend to vaccinate. Health-worker recommendation is the principal positive driver for vaccination, while low risk perception, safety concerns, and lack of information were common barriers. Acceptance was associated with gestational age, parity, and educational level.ConclusionsInfluenza showed high prospective acceptance, whereas COVID-19 and RSV had low coverage in pregnancy and more uncertainty. Strengthening timely health-worker recommendations, addressing risk perception and safety concerns, and improving access to information and services may enhance maternal immunization in Argentina.