Publication date: Jul 01, 2025

The coronavirus disease of 2019 (COVID-19) vaccination has reduced the severity of illness and hospitalization rates associated with the virus. However, pregnant and lactating refugee women often have lower vaccination rates, which are influenced by limited access to healthcare, cultural barriers, and misinformation. This study, guided by the Positive Deviance Framework, examines the factors that promoted COVID-19 vaccination among pregnant and lactating refugee women. Cultural Health Navigators conducted in-depth interviews with pregnant and lactating refugee women recruited from a large federally qualified health center who received COVID-19 vaccines. This qualitative study included 30 participants, stratified by language groups and representing diverse educational backgrounds and lengths of residence in the United States. Thematic analysis of the interviews revealed factors such as fear of COVID-19, emotional relief following vaccination, trust in healthcare providers and scientific evidence, and support from family and Cultural Health Navigators. The findings highlight the importance of culturally sensitive communication and trust-building in promoting vaccination rates among pregnant and lactating refugee women. Trust in healthcare providers, scientific evidence, and support from family and Cultural Health Navigators played a key role in overcoming vaccination barriers. Tailored strategies and supportive interventions can enhance COVID-19 vaccination uptake in this population. Further research in larger, diverse populations is needed to identify additional strategies for improving vaccination rates among refugee women.

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Original Article