Experiences and Perceptions of Jordanian Women toward the Effects of COVID-19 and Its Vaccine on Reproductive Health

Abstract

This study aims to explore the experiences and perceptions of Jordanian women regarding being infected with the coronavirus and its vaccine on their reproductive health.

A qualitative phenomenological approach was used. Snowballing and volunteering approaches were used to interview nineteen Jordanian women who met the following inclusion criteria: Jordanian women of reproductive age (18–45 years); had been infected with coronavirus; married; sexually active; have a menstrual cycle; and who are willing to participate. Invitations for participation were sent via social media groups (WhatsApp and Facebook groups). Then, face-to-face semi-structured interviews were conducted in a quiet place and were digitally recorded. All interviews were transcribed verbatim and analyzed using Giorgi’s manual thematic analysis.

Three major themes emerged: “We are not like before,” with the following subthemes: “Enduring physical strains” and “Enduring emotional strains”; “Our reproductive health is affected,” with the following subthemes: “Menstrual disturbances,”“Sexual life fluctuation,” and “Pregnancy and breastfeeding uncertainty.” The third theme was “Women’s internal conflict about the Covid-19 Vaccine,” with the following subthemes: “Upset from being felt obliged to take the vaccine” and “No intention to take further doses,”“Uncertainty about the manufacturing of the vaccine.”

Jordanian women still report of different long-lasting complications and disturbances from the COVID-19 infection and its vaccine on their reproductive health. Findings from the current study may help healthcare professionals recognize Jordanian women’s needs regarding their reproductive health. Healthcare professionals and policymakers might also suggest the quality of care provided to those women who had challenging experiences. Perceptions of refusal of the COVID-19 vaccine and uncertainty about manufacturing were evident in the current study. Therefore, more effort from the government and policymakers is needed to correct the image of vaccine safety to suggest immunity among those women.

Plain Language Summary

To explore the experiences and perceptions of Jordanian women towards being infected with the coronavirus and its vaccine on their reproductive health. Methods: a qualitative phenomenological approach was used. Snowballing and volunteering approaches were used to interview nineteen Jordanian women if they met the following inclusion criteria: Jordanian women of a reproductive age (18-45 years); had been infected with Coronavirus; married; sexually active; have menstrual cycle;

To explore the experiences and perceptions of Jordanian women towards being infected with the coronavirus and its vaccine on their reproductive health. A qualitative phenomenological approach was used. Snowballing and volunteering approaches were used to interview nineteen Jordanian women if they met the following inclusion criteria: Jordanian women of a reproductive age (18-45 years); had been infected with Coronavirus; married; sexually active; have menstrual cycle; and who are willing to participate. Invitations for participation were sent via social media groups. Then, face-to-face semi-structured interviews were conducted at a quiet place and were digitally recorded. Giorgi's manual thematic analysis was used. Three major themes emerged; “We are not like before” with the following subthemes “Enduring physical strains” and “Enduring emotional strains”; “Our reproductive health is affected” with the following subthemes “Menstrual disturbances”, “Sexual life fluctuation”, and “Pregnancy and breastfeeding uncertainty”. The third theme was “Women’s internal conflict about Covid-19 Vaccine” with the following subthemes “Upset from being forced to take the vaccine” and “No intention to take further dose”, “Uncertainty about the manufacturing of the vaccine”. Jordanian women complain of different long-lasting disturbances from the COVID-19 infection and its vaccine on their reproductive health. Findings may help healthcare professionals to recognize Jordanian women's needs regarding their reproductive health. Healthcare providers and policymakers can enhance the quality of care for women who have had negative experiences. Greater efforts from the government are necessary to improve the perception of vaccine safety and boost immunity among these women.

Keywords

COVID-19 COVID-19 vaccine Jordanian women reproductive health women’s perceptions

Introduction

The spread of the Coronavirus disease (COVID-19) in 2019 has resulted in a significant global pandemic crisis. Public health emergencies like COVID-19 can profoundly affect various aspects of health, including reproductive health (Li et al., 2020). Reproductive health encompasses the reproductive system, its functions, and processes throughout all stages of life (WHO, 1999). It includes physical, mental, and social health aspects that are vital for maintaining the quality and number of future generations (Li et al., 2020). Clinicians and the public have expressed considerable concern about the impact of COVID-19 on reproductive health (Li et al., 2020; Ozimek et al., 2022; Sansone et al., 2021). The ongoing pandemic and its associated treatments and vaccines have raised significant worries regarding challenging consequences on various components of reproductive health, such as sexual life, menstrual cycles, fertility issues, and violence (Aolymat, 2021; Li et al., 2020).

To address these concerns, numerous research studies have been conducted (Li et al., 2020; Phelan et al., 2021; Sansone et al., 2021). For example, researchers suggest that COVID-19′s potential to attack ovarian tissues and granulosa cells may affect sperm, ovarian function, and oocyte quality, potentially leading to female infertility, miscarriage, and adverse pregnancy outcomes (Li et al., 2020). Studies have also shown changes in sexual behaviors during the pandemic, including increased sexual frequency alongside decreased desire (Phelan et al., 2021; Sansone et al., 2021). Other research has linked COVID-19 infection and pandemic-related stress to menstrual cycle irregularities (Ozimek et al., 2022; Phelan et al., 2021). Evidence indicates complex interactions between stressors and psychological illnesses, highlighting the importance of understanding how panic psychology during the COVID-19 pandemic impacts reproductive health (Ullah et al., 2020). An Egyptian study found that women experienced higher levels of anxiety and depression than men, leading to a greater risk of sexual dysfunction and dissatisfaction. Notably, sexual satisfaction decreased during lockdown, from 73.5% before to 56.2% during (Omar et al., 2021).

Since the onset of the COVID-19 pandemic, many vaccines have been developed. Creating effective and safe vaccines for all populations is crucial for reducing COVID-19 morbidity and mortality and increasing community immunity (Lurie et al., 2020). Numerous studies have assessed COVID-19 vaccine acceptance, particularly among women, revealing varying beliefs and perceptions about vaccination. According to Walker et al. (2021), vaccination hesitancy is among the top 10 global health threats that could challengingly impact vaccine uptake. Those who reject vaccines tend to hold strong challenging views, while those who accept them generally have strong positive beliefs (Walker et al., 2021). Although COVID-19 vaccines have been demonstrated to be safe, with no known effects on reproductive health for either sex (Brumfiel, 2021), concerns about their efficacy and safety have been partly fueled by misinformation circulating in mainstream media and online since December 2020. A large-scale study by Diaz et al. (2022) indicated that worries about challenging effects on fertility were a major factor in vaccine hesitancy among the U.S. population. Conversely, another study advised women to dismiss concerns about COVID-19, noting a lack of evidence for adverse effects on fertility (Safrai et al., 2021). Despite these contradictions and global hesitancy among women, research on similar concerns in Jordan remains limited. Most existing studies have focused on the effects of COVID-19 on reproductive health during the pandemic and lockdown, with a notable lack of research exploring these effects post-COVID-19, particularly qualitative studies. Therefore, this study aims to investigate the experiences and perceptions of Jordanian women regarding the impact of COVID-19 infection and vaccination on their reproductive health.

Methods

Study Design and Sample

A phenomenological qualitative approach was used to explore Jordanian women’s experiences after being infected with COVID-19 and receiving its vaccine. Descriptive phenomenology is concerned with revealing the “essence” or “essential structure” of any phenomenon under investigation. Phenomenology is also the lived experience of humans from the world of their everyday lives. These experiences tell them what is real and true in life and gives meaning to their perception of a particular phenomenon which can be influenced by internal and external factors (Giorgi, 1985). The chosen methodology in the current study is not intended to provide generalized results, but to understand the perception and experience of Jordanian women’s experiences after being infected with COVID-19 and receiving its vaccine and explore their challenges and needs. Snowballing and volunteering approach was used to interview nineteen Jordanian women if they met the following inclusion criteria: Jordanian women in a reproductive age (18–45 years), being infected with the Coronavirus, married, sexually active and have menstrual cycle, and who were willing to participate. Women who were not infected with the Coronavirus, women with hormonal problems or any disease that affects their cycles, and women with premenopausal symptoms and menopause age were excluded.

Ethical Considerations

Before conducting the study, appropriate ethical approval was obtained (REF: 2022/191). Written consent was acquired to ensure complete voluntary participation. Women were informed that they could withdraw at any time without consequences. Detailed information about the study’s purpose, as well as the potential risks and benefits of participation, was provided to participants. No coercion was exerted by the researcher. All data were kept confidential, but the information may be used in nursing publications or presentations in a manner that does not identify participants. Participants were reassured that there were no invasive procedures or risks associated with the study. They were also informed that their interviews would be digitally recorded. All identifying information and recordings were discarded after the study’s completion.

The research used qualitative methods through semi-structured face-to-face interviews, avoiding medical procedures and invasive techniques to protect participants from physical harm. The benefits outweighed the minimal risk of discomfort when discussing health experiences. Participants expressed concerns about COVID-19 infection and vaccination that they felt were neglected by healthcare professionals and policymakers. This opportunity likely helped participants feel validated and empowered. The findings provide important insights into how COVID-19 affects reproductive health and how Jordanian women view vaccination. They will assist healthcare providers in delivering more compassionate care and developing public health strategies to address vaccine reluctance and reproductive health issues. The advantages for participants and society outweighed the small potential risks of the study.

Data Collection

Invitations for participation were sent via social media groups (WhatsApp and Facebook). Potential participants were contacted, and a suitable date and location for meetings were arranged. Semi-structured, face-to-face in-depth interviews were conducted in Arabic, with some taking place at the participants’ homes and others at the researcher’s office. Participation in the study was voluntary, and data collection continued until saturation was reached. Each interview lasted between 20 and 30 min and occurred at a time and place convenient for the participants in a quiet environment. The researcher conducted all interviews, which were digitally recorded. Data lasted for 1 month duration, from 1st of October to the 1st of November 2022.

With permission, the interviews were guided by the following questions: “Could you please tell me about your experience of being infected with the Coronavirus and how it has affected your reproductive health?”“What are your perceptions of the COVID-19 vaccine, and what is your opinion about receiving it?” and “Do you have any suggestions or needs regarding this topic?” Additionally, various probing questions were asked to encourage women to share more about their experiences and to gain a deeper understanding. At the end of each interview, the researcher transcribed the conversations verbatim.

Data Analysis

Data were analyzed using Giorgi's (1985) methodology. Before translating the recorded interviews into English, they were listened to and replayed several times. The researcher, fluent in both Arabic and English, then translated the transcripts. The original Arabic and English translations were reviewed for consistency. The researcher examined and coded the transcripts, segmenting the information into units representing the unique perceptions and experiences of the participants. These units were organized into a table to create meaning units that aligned with the participants’ words.

To establish the foundation for the key categories, the researcher collected concepts and ideas from the transcripts, highlighted them, and noted them in the margins. Following this, several keywords were chosen as principal codes, leading to the development of descriptions and concepts that reflected the most frequent experiences of the women expressed through major themes. This process was repeated multiple times before finalizing the themes.

Conformability, credibility, and transferability were employed to maintain the trustworthiness of the findings. “Bracketing” was used to demonstrate conformability, while member verification was utilized to validate credibility. Six participants received a copy of the results to ensure that the information and its interpretation accurately reflected their experiences. The use of excerpts from respondents’ interviews to describe the data analysis in depth assured transferability.

Findings

Sample Demographics

Participants’ ages ranged from 27 to 45 years (average age = 36.1 years). Most participants were educated, holding a diploma or higher degree. Only three women had a high school education. Seven women were unemployed, while the others were employed in various professions. All women identified as Muslim and were married. Only two women did not receive the COVID-19 vaccine (see Table 1).

Table 1.

Participant’s Demographic Data.

ID	Age	Place of residence	Religion	Education level	Marital status	Income JD	Employment status	No. children	Infected of COVID-19	Received covid-19 vaccine
1	40	City	Islam	Diploma	Married	600	Nurse	4	Yes	Yes
2	27	City	Islam	Bachelor	Married	700	No work	2	Yes	No
3	37	Village	Islam	Bachelor	Married	1,800	Nurse	5	Yes	Yes
4	36	City	Islam	Bachelor	Married	700	Teacher	4	Yes	Yes
5	34	Village	Islam	Diploma	Married	800	Clark work	4	Yes	Yes
6	38	City	Islam	Diploma	Married	1,000	No work	4	Yes	Yes
7	41	City	Islam	PhD	Married	3,000	Professor	2	Yes	Yes
8	35	Village	Islam	High school	Married	400	No work	3	Yes	No
9	30	Village	Islam	Bachelor	Married	900	Nurse	2	Yes	Yes
10	40	City	Islam	PhD	Married	3,000	Professor	4	Yes	Yes
11	39	City	Islam	High school	Married	300	No work	4	Yes	Yes
12	37	City	Islam	Bachelor	Married	1,200	Teacher	2	Yes	Yes
13	29	City	Islam	High school	Married	900	No work	2	Yes	No
14	45	City	Islam	PhD	Married	4,000	Professor	5	Yes	Yes
15	33	Village	Islam	Bachelor	Married	600	Social advisor	2	Yes	Yes
16	37	City	Islam	Master	Married	1,500	Lecturer	2	Yes	Yes
17	42	City	Islam	Diploma	Married	1,000	No work	4	Yes	Yes
18	38	City	Islam	Diploma	Married	800	Nurse	4	Yes	Yes
19	28	City	Islam	Diploma	Married	500	No work	2	Yes	Yes

Main Themes

This study explored the perceived experiences of Jordanian women after being infected with COVID-19 or receiving its vaccine. Various complications, feelings, emotions, and thoughts emerged as consequences of the COVID-19 crisis.

We Are Not Like Before

Enduring Physical Strains

All participants acknowledged a decline in their energy levels for physical activities following their COVID-19 infection. They frequently reported experiencing fatigue and shortness of breath during daily house cleaning and while climbing stairs. One woman stated:

Im not the same person now as I was before being infected by the coronavirus. I live on the third floor and used to go upstairs easily. However, after a few weeks of being infected with the virus, a big change happened. It’s not me anymore. Now I get tired and experience shortness of breath on the second floor.

Another woman remarked:

After the COVID-19 infection, I noticed a significant change in my ability to do housework. For example, before COVID, I could clean all the rooms in my house in one day. Now, I can’t clean more than one room in the same day.

Some participants reported that they began to suffer from severe headaches following their COVID-19 infection. Before their illness, these women rarely experienced such frequent and intense headaches.

One participant said: “The main change I have experienced after being infected with the coronavirus is severe headaches. Now I have headaches that are more intense and frequent than before, which require taking analgesics to subside.”

All women in the study noted a significant change in their musculoskeletal functions. Joint pain and muscle aches were commonly reported among most participants.

One woman stated: “After the COVID infection, my joint pain persisted. Now, my joint pain is the main change that I have experienced.”

Another woman added: “My joints, muscles, and everything else in my body are aching and painful.”

Some participants noticed an increase in seasonal flu symptoms at the time of data collection. They reported more frequent, severe, and prolonged bouts of flu. One participant said:

This winter, I did not get well. I had the flu more than three times, and each time it lasted for 10 days or more. Sometimes I need to use a nebulizer at the hospital to imsuggest my breathing. Even my children and all family members have had the flu. It’s different from last year.

Another woman commented: “This year is different. I have already had the flu three times, and we are still at the beginning of winter.”

Enduring Emotional Strains

Many participants had challenging experiences with COVID-19 infection and vaccination, expressing feelings of mortality. These experiences and fears affected their outlook on the future and resulted in emotional disturbances. Consequently, many participants conveyed persistent fears and worries about their families and the potential return of the disease or challenging consequences. One participant shared:

COVID-19 has shaken my life. After my experience with the virus and being close to death, I rearranged my life priorities. My fear and worries about leaving my children if I pass away have increased. I pay more attention to my children now.

Our Reproductive Health Is Affected

Menstrual Disturbances

All participants identified changes in their menstrual cycles as a significant alteration in their reproductive health. Some reported longer and heavier menstrual periods than before their COVID-19 infection, while others experienced irregular cycles and spotting between periods. Compared to their cycles prior to COVID-19, the remaining participants reported severe joint pain associated with menstruation that required analgesics. When asked about the primary change in their reproductive health, participants responded as follows:

After the coronavirus infection, my periods became heavier and longer than before.

This is the first time my period has been like this. Sometimes it comes after 20 days, sometimes after two months. I noticed this after taking the COVID-19 vaccine.

Yes, my period was affected after being infected with the coronavirus. I have severe abdominal and joint pain. I have never experienced this level of pain during my period.

The main change I experienced is in my menstrual cycle; it has become two days longer compared to before the COVID-19 vaccine, and sometimes I have spotting between periods.

Two participants reported developing functional ovarian cysts, reporting of menstrual disturbances and irregularities for 2 months after receiving the COVID-19 vaccine. Both were diagnosed with functional ovarian cysts.

The main issue I faced was developing a functional ovarian cyst after taking the COVID-19 vaccine. I still experience painful attacks from time to time.

Two months after receiving the COVID-19 vaccine, I had a very painful abdominal attack, and when I went to the doctor, I was diagnosed with an ovarian cyst.

Sexual Life Fluctuation

The participants reported varied experiences regarding sexual activity. Some women noted that their levels of desire and frequency remained unchanged compared to before the COVID-19 infection or after vaccination. In contrast, others experienced increased desire and frequency of sexual intercourse, attributing this to the challenging circumstances and challenging experiences during the COVID-19 infection, which brought them closer to their partners. Conversely, a few participants reported a decline in desire and frequency of sexual intercourse, suggesting that this may be one of the adverse outcomes of COVID-19 and its vaccine.

One woman stated: “After COVID, our sexual life was affected. The desire and frequency of sexual intercourse decreased. For example, we used to have sex two to three times a week, but now we have it only once.”

Another woman reported, “No changes have occurred in my sexual desire or my husband’s. Our sexual life after the COVID-19 infection is the same as before.”

You know, we experienced very difficult times and long lockdowns. I think we needed to be together as a family, and our feelings of love increased, which is why our frequency and desire increased.

Pregnancy and Breastfeeding Uncertainty

Some participants experienced COVID-19 infection while pregnant or breastfeeding, leading to differing perceptions. Two participants reported high levels of stress during pregnancy due to concerns about their babies’ health. One participant faced significant challenges during her infection while breastfeeding. Another participant expressed concerns about the vaccine’s potential impact on her baby’s health, as she received the vaccine while breastfeeding. They also highlighted the challenging effects of COVID-19 on their babies’ growth and development. Some participants postponed their pregnancy plans to avoid unexpected challenging outcomes.

However, some participants found comfort in their religious beliefs and reliance on God, which helped them feel more at ease and less fearful. Those who held this belief breastfed their babies without worry, believing that breastfeeding would enhance their babies’ immunity.

I was surprised to see my pregnant colleague wearing two masks and two gowns. I didn’t worry to that extent; I believe that Allah (God) will often protect me and my baby.

To be honest, I postponed my pregnancy plans because I was unsure about the effects of the coronavirus and the vaccine on my body. I will wait at least six months after receiving my last dose.

Women’s Internal Conflict About the COVID-19 Vaccine

Upset From Being Felt Obliged to Take the Vaccine

All participants were mandated to receive two doses of the COVID-19 vaccine. Each woman expressed anger about being compelled to take the vaccine, despite not being convinced of its necessity. Many women criticized government authorities for forcing them to vaccinate, even though they believed it was their right not to take it. The interviews revealed many unstable emotions, including refusal of further vaccines, fear of challenging consequences, and feelings of guilt for having taken the vaccine.

No Intention to Take a Further Dose

All participants expressed their refusal to take an additional dose of the COVID-19 vaccine. Some justified their refusal by citing uncertainty about the vaccine’s effectiveness. Others highlighted their fears and worries about potential side effects and challenging consequences, emphasizing that they preferred to develop natural immunity through infection.

If the government offers a third dose of the COVID-19 vaccine, I will hesitate. There’s no need for it; I have already developed natural immunity after having the infection.

If someone asks me to take an extra dose of the COVID-19 vaccine, I will hesitate because we were felt obliged to take it last time, and I believe the challenging effects are still unknown.

I’m not sure if this vaccine is good or not. When I took the first two doses, I experienced some changes and discomfort.

Uncertainty About the Manufacturing of the Vaccine

All participants expressed hesitation about the vaccine due to a lack of trust in its manufacturing. Several women researched the vaccine and its manufacturers, realizing that conclusive evidence regarding its quality was lacking. Others feared unknown side effects and potential challenging consequences that could arise in the future.

Initially, I hesitated to take the vaccine because it’s a new product, and no company had reliable information about it. Another woman stated, “I did not trust the vaccine. We see the problems and mistakes of the companies. If I had the option to hesitate it, I would not take it.”

Another woman elaborated, “Even scientists do not fully understand the side effects of the vaccine; they are still studying it.”

Discussion

This study uncovered a range of reports among Jordanian women of reproductive age following COVID-19 infection or vaccination. All participants reported challenging physical changes, including general fatigue, shortness of breath, headaches, and joint pain. Additionally, some experienced colds and flu more frequently than before. Similar health issues have been documented by the World Health Organization (2023), the Centers for Disease Control and Prevention (CDC, 2023), and Shanbehzadeh et al. (2021), who reviewed 34 articles with follow-up periods of up to 3 months post-COVID-19. Beyond these physical challenges, women in this study reported emotional disturbances stemming from the significant upheaval of the COVID-19 crisis. Comparable feelings of stress and anxiety have been well-documented in previous reports (CDC, 2023; World Health Organization, 2023) and international studies (Demir et al., 2021; Shanbehzadeh et al., 2021).

Many reproductive system changes were reported in this study. Most women experienced menstrual disturbances like those identified by Sharp et al. (2022) and Lebar et al. (2022). These disturbances included changes in the frequency, duration, volume, and pain associated with the menstrual cycle. For some, periods became longer and more irregular, while others noted increased joint pain and headaches linked to their menstrual cycles compared to before their COVID-19 infection. Sharp et al. (2022) suggested that COVID-19 may be associated with endothelial cell dysfunction and alterations in the coagulation system, both vital for endometrial function during menstruation, indicating a possible endometrial mechanism for menstrual disturbances. Demir et al. (2021) found a strong correlation between stress and anxiety related to COVID-19 and menstrual changes. In our study, women reported stress and anxiety concerning both COVID-19 and its vaccine, supporting this explanation. Some participants noted menstrual changes after receiving the COVID-19 vaccine, a finding echoed in previous international studies. For example, Edelman et al. (2022) observed slight alterations in menstrual cycle length post-vaccination, though not in menstruation duration. In contrast, Alvergne et al. (2021) found that 20% of participants in a UK sample experienced menstrual disturbance, ranging from heavy bleeding to cessation of menstruation. However, the mechanisms by which vaccines influence menstrual characteristics remain poorly understood (Sharp et al., 2022).

The women in our study reported diverse changes in sexual activity due to COVID-19 infection. Some experienced a decline in sexual desire and frequency, aligning with findings from Omar et al. (2021), who noted lower sexual satisfaction during the COVID-19 lockdown compared to pre-crisis levels. Pascoal et al. (2021) identified various sexual problems associated with COVID-19, including difficulty achieving orgasm and low sexual desire. Conversely, some researchers found that certain women, particularly those in happy and stable relationships, reported increased sexual desire and frequency (Eleuteri et al., 2021; Phelan et al., 2021). Despite these studies being conducted during the pandemic, similar results emerged in our research. Changes in sexual activity have been linked to the stress and anxiety arising from the pandemic (Omar et al., 2021; Pascoal et al., 2021). Our participants continued to experience high levels of stress regarding COVID-19 and the potential complications of its vaccine.

Despite the increasing number of people vaccinated against COVID-19, all women in our study expressed reluctance to receive additional vaccine doses, citing concerns about the vaccine’s manufacturing and effectiveness. A recent meta-analysis of 22 Jordanian studies revealed that, although COVID-19 vaccine acceptance rates suggested to 33% in 2022, this figure remains below expectations, indicating a need for further awareness and outreach (Khabour, 2022). An earlier study by Sallam et al. (2021) found a low vaccine acceptance rate of 29.4% in Jordan, compared to higher rates in countries like Saudi Arabia (64.7%) and Indonesia, where acceptance exceeded 90% (Harapan et al., 2020). Sallam et al. (2021) supported our findings, noting that women exhibited higher levels of vaccine hesitancy due to distrust in the vaccine. Participants in our study echoed this sentiment, citing distrust in governments and pharmaceutical companies as contributing factors. Sallam et al. (2021) highlighted that the Jordanian women displayed more resistance to vaccination than men, potentially accounting for the views expressed in our research. This hesitancy may relate to a lower prevalence of vaccine and virus origin conspiracies among men, who tended to rely more on medical professionals, scientists, and academic journals, while women often turned to social media. Additionally, earlier research indicated that women were less likely to perceive the illness as severe, which may lead to lower vaccine acceptance due to complacency (Sallam et al., 2020). In our study, this hesitancy was particularly pronounced among women who were pregnant or breastfeeding. Masa’deh et al. (2023) concurred that woman considering pregnancy, pregnant, or breastfeeding in Jordan exhibited moderate COVID-19 vaccine reluctance, despite current international recommendations regarding its safety for women and their fetuses or neonates.

The findings may also reflect sociocultural influences specific to Muslim-majority contexts like Jordan, where religious faith, collective health beliefs, and governmental policy shape women’s perceptions of COVID-19 and its vaccine. In contrast to studies from non-Muslim countries that emphasize scientific reasoning and policy compliance (e.g., Edelman et al., 2022; Sharp et al., 2022), many Jordanian women relied on faith-based coping mechanisms, such as trust in divine protection during pregnancy and breastfeeding (Kasapoglu, 2020; Masa’deh et al., 2023). Islamic values and extended family roles often influence reproductive decisions, contributing to distinct narratives around vaccine safety. Moreover, widespread misinformation on social media and regional distrust toward Western pharmaceutical companies intensified feelings of coercion, particularly given governmental mandates. This dynamic echoes findings in other Muslim-majority societies, where religious and cultural beliefs intersect with biomedical advice to shape vaccine hesitancy (Freeman et al., 2022; Sallam et al., 2020).

Limitations

This study has limitations. While data saturation was achieved, the relatively short duration of some interviews may have restricted the depth of information gathered. Future studies could benefit from longer interviews to enhance understanding. The generalizability of the results is confined to similar situations and cultures. Including younger or less educated women might also provide different insights.

Conclusion and Recommendations

This study’s findings highlighted the persistent and long-lasting complications in the reproductive health of Jordanian women resulting from COVID-19 infection and its vaccine. These results contribute valuable insights into the experiences and perceptions of Jordanian women regarding the impact of the coronavirus and its vaccine on their reproductive health.

Interviews conducted in this study gathered various suggestions and requests from participants. Most women expressed appreciation for hygienic precautions and the reduction of cultural practices such as kissing and handshaking. They generally accepted these changes, believing that maintaining such precautions would help protect individuals from further infections. Participants also emphasized the need for more research to investigate the effects of COVID-19 infection and its vaccine on their health and that of their children.

Our findings can assist healthcare professionals in understanding the needs of Jordanian women during this challenging period. Additionally, healthcare professionals and policymakers can leverage this information to suggest the quality of care for women who have faced challenging experiences. The study also revealed concerns about vaccine refusal and uncertainty regarding vaccine manufacturing. Therefore, increased efforts from the government and healthcare professionals are essential to enhance public perception of vaccine safety and boost immunity among these women.

Footnotes

Acknowledgements

Deep thanks and gratitude go to all participants for their time and efforts taken to conduct this study.

ORCID iD

Karimeh Alnuaimi

Ethical Considerations

Ethical Approval and Informed Consent Statement: Ethical approval was obtained from the Institutional Review Board at Jordan University of Science and Technology (IRB REF: 17/148/2022). Participants were informed of their right to withdraw at any time without consequences. The study posed minimal risk to participants and ensured confidentiality and anonymity. The research complied with the APA Ethical Principles of Psychologists and Code of Conduct (American Psychological Association [APA], 2017), Section 8.05, with no foreseeable harm to participants.

Consent to Participate

All participants provided written informed consent prior to participation.

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability Statement

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

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