Maternal Vaccination Perceptions, Attitudes and Practices Among Urban Women Receiving Antenatal Care in Panama City: A Cross-Sectional Study

<jats:p>Background/Objectives: Maternal immunization is a public health priority within Panama's Expanded Programme on Immunization (EPI), yet coverage among pregnant women remains below target and little local evidence is available on perceptions and practices among women engaged in antenatal care. We aimed to describe vaccination-related perceptions, attitudes and practices in an urban, predominantly private-care sample and to explore factors associated with acceptance. Methods: We conducted a cross-sectional study in 204 pregnant women aged ≥18 years, recruited by convenience sampling and surveyed with an anonymous, self-administered questionnaire. Vaccine acceptance was defined as having received or intending to receive at least one recommended vaccine during the current pregnancy. Participant characteristics were summarized descriptively; bivariate analyses and multivariable Poisson regression with robust variance estimated adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs). Results: Acceptance was 93.1% (190/204). Most participants had higher education (88.2%) and private antenatal care (77.9%); all reported antenatal care. Healthcare professionals were the main information source (92.6%) and most trusted source (98.0%). A vaccination recommendation was reported by 84.3% of participants; 96.5% of reported recommendations came from healthcare professionals. Influenza was most frequently received (56.9%), RSV most frequently planned (51.5%), and COVID-19 most frequently refused (47.1%). Recommendation was associated with acceptance (adjusted PR 1.22; 95% CI 1.02–1.45; p = 0.029), but may reflect broader access to high-quality care. Conclusions: In this selected urban sample, acceptance was high among women engaged in antenatal care. The findings cannot characterize national acceptance; improving coverage likely requires equitable access to antenatal care, evidence-based counseling, recommendations, and vaccination opportunities.</jats:p>