IMPROVING COVID-19 VACCINATION UPTAKE IN HIV POSITIVE PREGNANT WOMEN IN NIGERIA

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A. Project Summary/Abstract With the current global devastation and loss of lives, livelihood, and share suffering as a result of the COVID-19 pandemic, especially with the weak health care systems and limited resources in Africa, there is need to conduct research that will provide valuable information on treatment and prevention options and to understand the peculiarities of different populations as they respond. The effective COVID-19 vaccines have been largely instrumental to success in fighting the pandemic in the last 18 months. While most countries in the developed world have vaccinated over 70% of their population, only 21 African countries have fully vaccinated between 10% and 19% of their populations. Nigeria has only vaccinated 7.2% of its adult population and boosted only 0.4% and there is currently no data of vaccination in pregnant women or HIV infected persons. Even with the improved access of vaccines to Africa, vaccine hesitancy continues to limit the ability to improve vaccine coverage in these countries. Our ongoing NIH funded BEAMING grant (5U01HD094658) situated at a tertiary hospital where we have conducted research for over 20 years and including two prospective natural history birth cohort studies in HIV is uniquely placed to rapidly provide information for the first time from this part of the world that is this vulnerable population. This supplemental submission builds on the BEAMING experience and infrastructure to address research questions of great public health importance on social and culture norms that could explain vaccine hesitancy in this vulnerable population. We plan to use the information to develop culturally and socially acceptable educational materials and sessions that target drivers of vaccine hesitancy in HIV pregnant women and their matched uninfected pregnant controls in Nigeria, with the objective of re-shaping policies and strategies towards improved COVID-19 vaccines uptake in preparation for other waves of SARS COV-2 or future pandemics through three specific aims. Aim 1 will document social and cultural reasons for COVID-19 vaccine hesitancy among pregnant women in Nigeria and whether HIV infection creates an additional layer of burden. Aim 2 will develop strategies and educational materials to improve COVID-19 vaccine hesitancy and coverage in this population based on responses obtained from Aim 1. Aim 3 will document for the presence of anti- SARS-CoV-2 antibodies in infected pregnant women with or without HIV-1 infection; and if possible, the presence of anti- SARS-CoV-2 passively transferred antibodies in their infants.