{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T18:02:48Z","timestamp":1778695368398,"version":"3.51.4"},"reference-count":56,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Houston Global Health Collaborative"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>COVID-19 vaccination during pregnancy has been recommended, but the perceptions related to uptake remain unexplored. This pilot study aimed to explore how perceptions influence COVID-19 vaccine uptake among a sample of 115 pregnant women in Kenya, recruited via WhatsApp. Data were collected using an adapted online questionnaire between May and October 2022. Logistic analyses assessed the relationship between COVID-19 vaccination uptake and the Theory of Reasoned Action (TRA) constructs: attitudes and subjective norms. COVID-19 vaccination coverage was 73%, with vaccine hesitancy estimated at 41.4% among the unvaccinated group. Most participants had completed college education and had good knowledge of COVID-19 vaccines. There was no significant effect of enrollment in WhatsApp pregnancy groups on attitudes toward COVID-19 vaccination. Pregnant women were concerned about vaccine effectiveness (31.1%), and almost one-half (47.3%) were discouraged from receiving COVID-19 vaccines. Positive attitudes towards vaccination were associated with COVID-19 vaccination (aOR 2.81; 95% CI 1.12\u20137.04; p = 0.027), but no significant relationship was found between COVID-19 vaccination and strong subjective norms (influences to get COVID-19 vaccines). Our findings suggest that strategies to improve vaccination should consider targeting attitudes and proximal social networks (friends\/family) to facilitate vaccination decision-making. WhatsApp can be used for research distribution and enhance the dissemination of accurate information.<\/jats:p>","DOI":"10.3390\/ijerph21010098","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T04:56:59Z","timestamp":1705381019000},"page":"98","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Knowledge, Attitudes, and Subjective Norms Associated with COVID-19 Vaccination among Pregnant Women in Kenya: An Online Cross-Sectional Pilot Study Using WhatsApp"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1169-1666","authenticated-orcid":false,"given":"Sylvia","family":"Ayieko","sequence":"first","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Jaoko","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Nairobi, P.O Box 19676, Nairobi 00202, Kenya"},{"name":"KAVI-Institute of Clinical Research, University of Nairobi, P.O. Box 19676, Nairobi 00202, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9967-5432","authenticated-orcid":false,"given":"Rose Okoyo","family":"Opiyo","sequence":"additional","affiliation":[{"name":"Department of Public and Global Health, University of Nairobi, P.O. Box 19676, Nairobi 00202, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1551-244X","authenticated-orcid":false,"given":"Elkanah Omenge","family":"Orang\u2019o","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health, Moi University, P.O. Box 3900, Eldoret 30100, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6685-2175","authenticated-orcid":false,"given":"Sarah E.","family":"Messiah","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA"},{"name":"Center for Pediatric Population Health, University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA"},{"name":"Department of Pediatrics, McGovern Medical School, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0587-894X","authenticated-orcid":false,"given":"Christine","family":"Markham","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"895","DOI":"10.15585\/mmwr.mm7024e2","article-title":"COVID-19 Vaccination Coverage Among Pregnant Women During Pregnancy\u2014Eight Integrated Health Care Organizations, United States, 14 December 2020\u20138 May 2021","volume":"70","author":"Razzaghi","year":"2021","journal-title":"Morb. 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