Psychological and situational factors associated with COVID-19 vaccine intention among postpartum women in Pakistan: a cross-sectional study

Shahirose Sadrudin Premji, Sahar Khademi, Ntonghanwah Forcheh, Sharifa Lalani, Kiran Shaikh, Arshia Javed, Erum Saleem, Neelofur Babar, Qamarunissa Muhabat, Nigar Jabeen, Sidrah Nausheen, Shahnaz Shahid Ali

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Objectives Contributing factors to COVID-19 vaccination intention in low-income and middle-income countries have received little attention. This study examined COVID-19-related anxiety and obsessive thoughts and situational factors associated with Pakistani postpartum women's intention to get COVID-19 vaccination. Design Cross-sectional study administering a survey by a telephone interview format between 15 July and 10 September 2020. Setting Four centres of Aga Khan Hospital for Women and Children - Garden, Kharadar, Karimabad and Hyderabad - in Sindh Province, Pakistan. Participants Women who were enrolled in our longitudinal Pakistani cohort study were approached (n=1395), and 990 women (71%) participated in the survey, of which 941 women who were in their postpartum period were included in the final analysis. Primary outcome measure and factors COVID-19 vaccine intention, sociodemographic and COVID-19-related factors, Coronavirus anxiety, obsession with COVID-19 and work and social adjustment were assessed. Multiple multinomial logistic regression analysis was used to identify factors associated with women's intentions. Results Most women would accept a COVID-19 vaccine for themselves (66.7%). Only 24.4% of women were undecided about vaccination against COVID-19, and a small number of women rejected the COVID-19 vaccine (8.8%). Women with primary education were less likely to take a COVID-19 vaccine willingly than those with higher education. COVID-19 vaccine uncertainty and refusal were predicted by having no experience of COVID-19 infection, childbirth during the pandemic, having no symptoms of Coronavirus anxiety and obsession with COVID-19. Predictors for women's intention to vaccinate themselves and their children against COVID-19 were similar. Conclusion Understanding the factors shaping women's intention to vaccinate themselves or their children would enable evidence-based strategies by healthcare providers to enhance the uptake of the COVID-19 vaccine and achieve herd immunity against Coronavirus.

Original languageEnglish
Article numbere063469
JournalBMJ Open
Issue number9
Publication statusPublished - 22 Sept 2022


  • COVID-19
  • anxiety disorders
  • depression & mood disorders
  • perinatology
  • public health


Dive into the research topics of 'Psychological and situational factors associated with COVID-19 vaccine intention among postpartum women in Pakistan: a cross-sectional study'. Together they form a unique fingerprint.

Cite this