Determinants of Maternal Vaccine Acceptance, Uptake, and Hesitancy Regarding Recommended Immunization During Pregnancy among Antenatal Women in Selected Districts of Uttar Pradesh: A Mixed-Methods Study

Abstract

Maternal immunization is a highly effective public health intervention that prevents morbidity and mortality in both pregnant women and infants. However, suboptimal vaccine coverage driven by vaccine hesitancy presents a major obstacle to maximizing these benefits in resource-limited and densely populated regions. This mixed-methods study examines the determinants of maternal vaccine acceptance, uptake, and hesitancy regarding recommended immunizations (such as Tetanus-Diphtheria [Td] and Influenza vaccines) among antenatal women across selected districts of Uttar Pradesh.

Through quantitative surveys and qualitative focus group discussions, this research highlights the critical role of frontline healthcare workers, maternal education, socio-cultural beliefs, and institutional trust in shaping immunization choices. The article details systematic screening pathways, standardized measurement tools, and evidence-based interventions required to overcome systemic and structural barriers. Emerging digital solutions, targeted community engagement, and family-centred counseling are proposed as essential mechanisms to reduce vaccine hesitancy and improve maternal health outcomes across the region.