Awareness, perception and Willingness to Accept Malaria Vaccination for Maternal and Child Protection among Pregnant Women Attending Antenatal Care: A Cross-Sectional Study

Background Nigeria contributes substantially to the global burden of malaria, with pregnant women and young children among the most vulnerable groups. With the recent introduction of malaria vaccines in several African countries, community awareness and acceptance are critical for successful implementation. This study assessed awareness, perceptions, and willingness to accept the malaria vaccine among pregnant women attending antenatal care in a tertiary hospital in Nigeria. Methods A hospital-based cross-sectional study was conducted among 274 pregnant women attending antenatal clinics at a tertiary health facility. Data were collected using a structured interviewer-administered questionnaire covering sociodemographic characteristics, awareness of the malaria vaccine, perceptions about vaccination, and willingness to accept the vaccine. Descriptive statistics summarized participants’ characteristics. Associations between explanatory variables and willingness to accept the vaccine were assessed using chi-square tests and logistic regression analysis. Statistical significance was set at p  < 0.05. Results The majority of participants were aged 20–34 years (75.5%), married (85.3%), and had tertiary education (55.1%). Awareness of the malaria vaccine was relatively low (48.5%). However, perceptions toward vaccination were largely positive: 86.1% believed vaccines prevent disease and 87.2% believed a malaria vaccine could protect against malaria. Overall, 81.0% of respondents were willing to receive the vaccine if available, and 79.9% were willing to vaccinate their children. Factors significantly associated with vaccine acceptance included belief in vaccine protection ( p  < 0.001), healthcare provider recommendation ( p  = 0.002), vaccine availability ( p  = 0.002), provision of safety information ( p  = 0.005), and free vaccination ( p  < 0.001). In multivariable analysis, belief in vaccine protection and healthcare provider recommendation remained independent predictors of vaccine acceptance. Conclusions Despite limited awareness, pregnant women demonstrated favourable disposition and high willingness to accept the malaria vaccine. Strengthening antenatal health education and leveraging healthcare provider recommendations may improve vaccine uptake and support effective malaria vaccine implementation in high-burden settings.