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Introduction: Contracting coronavirus disease (COVID-19) during pregnancy has been linked to an increased risk of severe maternal and fetal complications. Mass vaccination is considered a promising solution to successfully combat the COVID-19 pandemic. It includes vaccinating of pregnant and breastfeeding women. The success of a vaccine is determined not only by its efficacy, but also by its acceptability. Therefore, our study aimed to explore the acceptability and reluctance of pregnant and breastfeeding women to receive COVID-19 vaccination in Saudi Arabia. Methods: This cross-sectional study was conducted in Saudi Arabia from March 2022-beginning to June 2022-end. Using an online self-administered questionnaire with a convenience sampling technique, we assessed women for pregnancy, gravidity, parity, high-risk pregnancy, trimester of pregnancy, and current or planned breastfeeding. Furthermore, we assessed patients with preexisting chronic illnesses. The questionnaire comprised sociodemographic data and items drawn from Goncu Ayhan et al, including vaccination history, perception of risk related to the COVID-19 pandemic, impact of the COVID-19 pandemic, and acceptance and attitude toward future COVID-19 vaccination. Results: A total of 854 women (615 pregnant and 192 breastfeeding women) were included. Predictors of COVID-19 vaccination acceptance were found in women with a high level of education, those who lived with an elderly family member, and had close contact with a COVID-19-positive person. The reasons for declining vaccination included COVID-19 diagnosis during pregnancy and concerns about side effects of COVID-19 vaccines. A total of 503 (58.9%) women believed that COVID-19 vaccines had the potential to harm their babies. Only 415 (48.6%) agreed they would take the COVID-19 vaccine if it were recommended for pregnant women. Conclusion: Pregnant and breastfeeding women fear COVID-19 vaccination due to safety concerns for their babies. COVID-19 vaccine acceptance varies among pregnant and breastfeeding women, regardless of whether they receive the COVID-19 vaccine. Our study underlines the importance of public education campaigns to improve the overall quality of information on COVID-19 vaccination, particularly among pregnant and breastfeeding women.
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