COVID-19 vaccine uptake and infection among pregnant women in Libya: a cross-sectional study.

BACKGROUND: Early in the pandemic, due to the novelty of SARS-CoV-2 (the virus that causes COVID-19), herd immunity did not exist, placing all populations at risk, with pregnant women at higher risk. The aim of this study is to evaluate previous COVID-19 infection and vaccination status among Libyan pregnant women to inform evidence-based maternal health interventions and public health planning. METHODS: In this observational cross-sectional study, 840 pregnant women were enrolled at five tertiary hospitals in three major cities in Libya from March 2023 to February 2024. Informed consent was obtained from all subjects involved in the study. Sociodemographic information, history of COVID-19 infection and vaccination were collected from all participants. RESULTS: Mean age of pregnant women was 31.1 ± 6.2 years. 191 (22.7%) women reported infection with COVID-19, most of them had mild disease (62.3%). Of those, 75 women (39.2%) had repeated COVID-19 infection. 219 women were vaccinated (26.1%), 68 of them had received vaccine booster (31.1%) and 22 vaccinated women (10%) had breakthrough infection. Occupation was an independent predictor of both infection and vaccination status (P-value < 0.001 for both). On the other hand, age and education level were not significant predictors for both infection and vaccination status. CONCLUSIONS: In this study, most pregnant women in Libya were unvaccinated against COVID-19. These findings emphasize the need for targeted strategies to increase vaccine uptake in antenatal care settings and to address barriers among this vulnerable population.