Background: Maternal immunization is a successful and most costeffective public health strategy that protects pregnant women and their infants from vaccine-preventable diseases directly associated with reduced morbidity and mortality. Uganda is exploring the introduction of new vaccines that target pregnant women in addition to Tetanus Toxoid (TT) and in the process of replacing Tetanus Toxoid (TT) with Tetanus-Diphtheria (Td). However, research exploring knowledge, attitudes, beliefs, and acceptability is still missing. Objectives: To explore the knowledge, attitudes, beliefs and vaccine acceptability among pregnant women in rural Uganda. Methods: A qualitative descriptive study explored the willingness, knowledge, attitudes, beliefs and acceptability of maternal immunization. Focus group discussions were conducted in the community and at antenatal care clinics. Data were thematically analyzed. Results: Ten focus group discussions (FGDs) were conducted among 90 pregnant women. Women were willing to take on any new vaccines, had good attitude towards maternal immunization and were familiar with its importance. The pregnant women partners' role in health decision making was an important factor to accept a new vaccine. Acceptance of a new vaccine could be affected by worries about negative adverse effects and events (AE). There are misconceptions regarding the introduction of vaccines like being tested on a small group of mothers and being seen as a treatment for common diseases like malaria and general body weakness. Women also highlighted cultural and religious misconceptions related to vaccination. Conclusions: Maternal immunization knowledge, willingness, attitudes, and acceptability among pregnant women was positive. However, fear for AE related to new vaccines, religion and cultural beliefs, coupled with the thinking that vaccines are for curing diseases like malaria and general body weakness, might counteract maternal immunization acceptability.
