U.S. CDC and Partners Collaborate to Vaccinate More Pregnant Women in El Salvador Against COVID-19


  • By February 2022, more than 70 percent of El Salvador’s population received 2 doses of COVID-19 vaccine, months earlier than the June goal set by the World Health Organization.
  • Health officials were concerned that pregnant women were not as up to date on their COVID-19 vaccines.
  • U.S. CDC staff working in El Salvador collaborated with the ministry of health and partners to develop and launch an education campaign to encourage more pregnant women to get the COVID-19 vaccine.

On November 26, 2021, the world learned about a new variant of concern called Omicron. Within a month, this new, more contagious form of the virus that causes COVID-19 spread around the world. To reduce deaths and severe illness caused by COVID-19, the World Health Organization (WHO) called on all countries to vaccinate 70 percent of their population by mid-2022.

By February 2022 – less than a year after launching the first vaccination campaign – more than 70 percent of El Salvador’s population received their first two doses of the COVID-19 vaccine, which was higher than the goal set by WHO.

However, health officials were concerned that the percentage of pregnant women who were up to date with their COVID-19 vaccinations was lower.

Four health workers at a clinic in Santa Ana, El Salvador stand in front of a woman who is sitting. They use puppets to explain how people expecting a baby benefit from getting the COVID-19 vaccine.

Health workers at the Mejicanos Family Community Health Unit in San Salvador, El Salvador, hold hand puppets for an educational campaign created by U.S. CDC staff, the Ministry of Public Health, and partners to get more pregnant women vaccinated against COVID-19. The puppets resemble a coronavirus with eyes and a mouth, a child, and a man. Photo by Diana Rivas/ASOPEDES

Three people conduct a training session session at the Los Cebollines restaurant in San Salvador, El Salvador. They are using hand puppets to explain the effects of COVID-19.

Health workers are conducting a training session for members of the community in a restaurant in San Salvador, El Salvador. They are showing how using these hand puppets can help explain to parents, children, and other relatives why pregnant women should get the COVID-19 vaccine. Photo by Diana Rivas/ASOPEDES

Staff from the U.S. Centers for Disease and Prevention (U.S. CDC) working in El Salvador collaborated with partners Asociación de Pediatría de El Salvador (Pediatric Association of El Salvador) and The Task Force for Global Health. They developed educational materials that explained how getting the COVID-19 vaccine will keep women as healthy as possible during their pregnancies.

From August to September 2022, the U.S. CDC and partners worked with the El Salvador Ministry of Public Health (MINSAL) to develop and launch an educational program that explained why it’s important for pregnant women to get vaccinated against COVID-19.

“The successful partnership with the El Salvador Ministry of Public Health led to the creation of communication and educational materials that helped new parents learn about the benefits of vaccines to protect themselves and their babies,” said Rafael Chacón, MD, who investigates disease outbreaks for U.S. CDC in the Central American region.

Three women each hold a different puppet used to explain how COVID-19 vaccine helps prevent serious illness. The first puppet is a coronavirus with eyes and a mouth. The second is a puppet of a girl. A third is a puppet of a man.

Health workers at the Tomas Pineda Family Community Health Unit in Santa Ana, El Salvador, council a pregnant woman about COVID-19 vaccines using hand puppets.
Photo by Diana Rivas/ASOPEDES

A health worker in a clinic in El Salvador gives a pregnant woman a COVID-19 vaccine.

This woman is getting the COVID-19 vaccine at the Montserrat Family Community Health Unit in San Salvador. She is one of many pregnant people who received the vaccine after El Salvador’s health ministry launched a U.S. CDC-supported COVID-19 vaccination campaign in August 2022. Photo by Diana Rivas/ASOPEDES

Teaching Future Parents and Caregivers to be COVID-19 Free

The goal was to explain to mothers at any point in their pregnancy why they need to get a COVID-19 vaccine. Health officials also wanted to reach close relatives of pregnant women who influence their decision to get the vaccine.

The education campaign was also designed to give COVID-19 prevention information to health workers caring for pregnant women in different medical settings, religious leaders, and other key members of the community.

The purpose of this educational campaign was to provide counseling and guidance – over the phone and in-person – to expectant and potential parents, as well other relatives.

The U.S. CDC and MINSAL developed lesson plans and other educational materials to teach pregnant women that it’s important to get the COVID-19 vaccine because they are more likely to get very sick from COVID-19 compared to people who are not pregnant.

They created flipcharts, pamphlets, posters and play materials such as puppets. These educational materials – especially the puppets – were very well received by the health workers because it kept the interest of participants they were counseling.

Forty-eight MINSAL outpatient facilities in the five health regions of El Salvador participated in the project with 814 participants. Two hundred eighty-five were pregnant.

At the end of the program, two-thirds of the unvaccinated participants received a dose of COVID-19 vaccine.

The results of this pilot program were so positive, that the COVID-19 materials are being integrated into the health ministry’s official educational material.

All the art and materials were donated to El Salvador’s MINSAL for use across the country.

This photo shows two sets of hands, each holding a pamphlet about COVID-19 which was developed by staff from U.S. CDC, El Salvador’s ministry of health, and other partners.

These pamphlets were created for a U.S. CDC-supported COVID-19 vaccination campaign launched by El Salvador’s Ministry of Public Health in August 2022. Photo by Diana Rivas/ASOPEDES