Acceptability of a Hypothetical Zika Vaccine among Women from Colombia and Spain Exposed to ZIKV: A Qualitative Study

Abstract

Zika virus (ZIKV) can cause pregnancy loss and congenital Zika syndrome, among other poor health outcomes. The ZIKV epidemic in 2015–2017 disproportionately affected pregnant women in poor-resource settings. We aimed to understand perceptions and attitudes towards a hypothetical ZIKV vaccine, women’s willingness to be vaccinated, and potential barriers and facilitators for vaccine acceptance in 1) migrant women living in Spain who travelled to their countries of origin and were diagnosed with ZIKV infection during pregnancy, and their healthcare providers, and 2) women living in Colombia who delivered a child with microcephaly. An exploratory qualitative study based on phenomenology and grounded theory was conducted. Data were collected through in-depth, paired and semi-structured interviews. Overall, women from both sites were willing to receive a hypothetical ZIKV vaccine. However, some expressed concerns of being vaccinated during pregnancy, yet they would accept it if the vaccine was recommended by a healthcare professional they trust. Main fears towards vaccination were related to vaccine safety and potential adverse effects on child’s health. Women reported feeling hesitant to participate in a ZIKV vaccine trial. These results may contribute to guiding the effective delivery of future ZIKV vaccines among populations most at risk and particularly vulnerable.

Acceptability of Clinical Trials on COVID-19 during Pregnancy among Pregnant Women and Healthcare Providers: A Qualitative Study

“…Their answers referred to hypothetical participation, hence not being aware that enrolled participants actually counted on these sources at the time of recruitment. Nonetheless, their perspectives point to the right of pregnant women to decide about their participation in a trial after proper counseling from healthcare staff so that all possible risks and benefits of their participation are mentioned [18,19,22,23]. Therefore, there is a need to ensure an accurate communication channel in an empathetic atmosphere during the recruitment processes, especially in the delicate context of the COVID-19 pandemic.…”

“…Some of the factors influencing pregnant women's decisions to participate in a clinical trial might be a perceived personal benefit, quality of the information received, including communication on the risks and potential complications, the role of relatives in the decision-making process, the perceived voluntariness, uncertainties due to randomization as part of the research design, and unwillingness to take the study medication [19][20][21][22]. A qualitative study about the acceptability of a hypothetical ZIKV vaccine showed that women who had had a previous ZIKV infection during pregnancy hesitated to participate in a clinical trial; however, they would accept vaccination once the vaccine was commercialized [23].…”

Zika virus infection in pregnant women and their children: A review

“…However, a major barrier for evaluation of ZIKV vaccines is the current context of reduced incidence after the ZIKV epidemic, which limits the plans for clinical development through phase II and III clinical trials [95,96]. Some issues would also need to be considered such the ethical implications of study design of vaccine trials in pregnant women living in areas with ZIKV transmission within an epidemic context [93], and strategies to effectively enrol pregnant women in ZIKV vaccine trials, as willingness to participate in previous hypothetical ZIKV vaccine trials has been reported to be low [97].…”

Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students

“…Methodological limitations have also been found in the measures available for the evaluation of specific problems, such as attitudes towards papillomavirus (HPV) vaccines [ 22 ] or the scales developed to assess the confidence of parents towards childhood vaccination [ 23 ]. On the other hand, although it is true that attitudes towards vaccination vary according to the type of vaccine and the health problem [ 24 ], there are reasons to believe that a single measure can be an efficient way of identifying people with concerns related to vaccines in general [ 5 ]. A review of scales to study attitudes towards childhood vaccination reported that most shared indicators about beliefs about the benefits or importance of vaccination, confidence in vaccines and in health care providers, confidence in the legitimacy of authorities to require vaccination, vaccination harms, and perceived risks of infectious diseases [ 23 ].…”