We congratulate Naqvi et al.¹ on their study that reports knowledge, attitudes and practices of pregnant women regarding COVID-19 vaccination, from the Global Network for Women and Children’s Health Research.¹

This COVID-19 vaccine survey in seven LMICs indicated that knowledge regarding the vaccine’s effectiveness and safety was typically poor but did vary. Concerns regarding vaccine safety and effectiveness among pregnant women are an important focus for educational efforts to boost immunisation rates.¹ We agree that vaccine knowledge is a key component in deciding vaccination acceptance. Concerns about vaccine safety are often cited as the primary factor for hesitation.^{2, 3} It is useful to identify attitudes among priority groups in order to develop tactics that enhance uptake during the present pandemic.²

Fear of COVID-19 vaccination is a significant problem, with multiple causes. Patterns of reluctance can change over time, as data on the vaccine are rapidly accumulating. Thus, a good health education system is required to adapt and give accurate, up-to-date information to encourage mass vaccination among pregnant women. Nevertheless, there is evidence to suggest that few individuals who decline vaccination initially accept it a later stage, meaning that interventions that address vaccine hesitancy in pregnancy are needed.⁴

It should be noted that the situation in LMICs may be complicated at times: while local pregnant women may have correct knowledge, the desire to be vaccinated may be hampered by the fact that no effective vaccines are available. Thus, the inactivated COVID-19 vaccine is still the primary vaccine in many LMICs, even though it may not be the most effective vaccine against the new COVID-19 variant.

我们祝贺 Naqvi 等人。¹关于他们的研究报告了孕妇关于 COVID-19 疫苗接种的知识、态度和做法，来自全球妇女和儿童健康研究网络。^1个

这项在七个中低收入国家开展的 COVID-19 疫苗调查表明，人们对疫苗的有效性和安全性的了解通常很少，但确实存在差异。对孕妇疫苗安全性和有效性的担忧是提高免疫接种率的教育工作的一个重要重点。¹我们同意疫苗知识是决定是否接受疫苗接种的关键因素。对疫苗安全性的担忧通常被认为是犹豫的主要因素。^{2, 3}确定优先群体的态度有助于制定在当前大流行期间加强吸收的策略。^2个

对 COVID-19 疫苗接种的恐惧是一个重大问题，原因有很多。随着疫苗数据的迅速积累，不情愿的模式会随着时间的推移而改变。因此，需要一个良好的健康教育系统来适应并提供准确、最新的信息，以鼓励孕妇进行大规模疫苗接种。然而，有证据表明，最初拒绝接种疫苗的人很少会在后期接受它，这意味着需要采取干预措施来解决怀孕期间对疫苗犹豫不决的问题。^4个

需要注意的是，中低收入国家的情况有时可能很复杂：虽然当地孕妇可能有正确的知识，但由于没有有效的疫苗，可能会阻碍接种疫苗的愿望。因此，灭活的 COVID-19 疫苗仍然是许多中低收入国家的主要疫苗，尽管它可能不是针对新 COVID-19 变体的最有效疫苗。