Utilization of COVID-19 vaccine and factors among pregnant mothers in Dessie town, northeast Ethiopia: community- based cross-sectional study

Background: Hand washing, social distancing, and wearing face masks were key COVID-19 prevention strategies but were insufficient to fully control the pandemic. Immunization is crucial for ending the pandemic, especially for pregnant women who are at higher risk of severe illness and adverse outcomes like preterm birth. Despite this, there was limited research on COVID-19 vaccination among pregnant women in developing countries, including Ethiopia. This study aims to evaluate the uptake of COVID-19 vaccination and identify associated factors among pregnant women in Dessie town, northeast Ethiopia, in 2023. Methods: A community-based cross-sectional study was conducted in 2023 on 581 pregnant women in Dessie town, northeast Ethiopia. Participants were selected using a multistage sampling technique. Data was collected using a pre-tested and validated self-administered structured questionnaire covering socio-demographic characteristics, knowledge and attitudes towards COVID-19 vaccination, and obstetric factors. The data was entered into Epi-data version 4.6 and analyzed using SPSS version 25. Multiple logistic regression analysis was performed to identify factors associated with COVID-19 vaccine uptake, with statistical significance set at p-value < 0.05. Results: Of all respondents, only 97 (16.7%; 95% CI: 13.8%-19.9%) had taken the COVID-19 vaccine, with 52 (9%) receiving one dose, 33 (5.7%) receiving two doses, and only 12 (2.1%) being fully vaccinated. Factors significantly associated with COVID-19 vaccine uptake included positive attitude towards the vaccine (AOR 3.2, 95% CI: 1.82-5.61), good knowledge about the vaccine (AOR 2.6, 95% CI: 1.4-4.83), having higher education (AOR 3.91, 95% CI: 1.49-10.31), urban residence (AOR 2.4, 95% CI: 1.15-5.02), receiving counseling to vaccinate by healthcare providers (AOR 4.97, 95% CI: 2.85-8.65), having medical disorders during pregnancy (AOR 2.53, 95% CI: 1.07-5.95), and family size greater than five (AOR 3.02, 95% CI: 1.74-5.23). Conclusion: COVID-19 vaccine uptake among pregnant women in Dessie town was very low, primarily due to safety concerns about potential side effects to the fetus and mothers. Positive predictors of vaccine uptake included urban residence, higher education, healthcare provider counseling, existing medical conditions, larger family size, good knowledge, and positive attitudes towards vaccination.