Psychological Determinants of COVID-19 Vaccination Uptake among Pregnant Women in Kenya: A Comprehensive Model Integrating Health Belief Model Constructs, Anticipated Regret, and Trust in Health Authorities

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.