Knowledge, perceptions and acceptance of COVID-19 Vaccine in Plateau States, Nigeria: A Qualitative Study.

Introduction and Objectives: Knowledge, perceptions, and acceptance of vaccines play a role in evaluating the progress of past immunization programs and planning for future pandemics. The study assessed the knowledge, perceptions, and acceptance of COVID-19 vaccines among pregnant women, HCWs, and policymakers in Nigeria and identified the barriers and enablers to the uptake of COVID-19 vaccines and future ones. Methods: The study adopted qualitative methods of qualitative collection, comprising focus group discussion (FGD) with pregnant women- who were HIV positive and negative- and key informant interviews (KII) with healthcare workers (HCWs) and policymakers in Plateau State, Nigeria. The sample comprised forty pregnant women, five HCWs and five policymakers. Data was managed using Dedoose (version 9.0) and analyzed thematically. Results: Although all sub-groups acknowledged the importance of vaccination, COVID-19 vaccine hesitancy was identified amongst a significant proportion of pregnant women. This was because of safety concerns, misinformation and fear of side effects. HCWs were identified as key influencers of vaccine acceptance during pregnancy. Also, family and friends, personal beliefs, and awareness were found to be influencers of vaccination, while religious and cultural beliefs were identified as barriers. Policymakers and HCWs believe that there is a need for education and awareness to address misinformation and improve the trust in vaccine safety and the health system among pregnant women. Conclusion: The participants were knowledgeable of vaccines. However, pregnant women expressed skepticism about the safety of the COVID-19 vaccines. Thus, addressing misinformation through public health awareness programs is important while leveraging the influence of the health workforce, community, and religious leaders in promoting vaccine acceptance.