The systematic exclusion of pregnant and lactating women from emergency vaccine campaigns creates a critical vulnerability during viral hemorrhagic fever outbreaks, where maternal mortality rates can exceed 90%. Understanding vaccine acceptance in these high-risk populations becomes essential as public health systems prepare for future Ebola outbreaks across sub-Saharan Africa. Researchers surveyed 424 pregnant and lactating women in Kampala following Uganda's 2022 Sudan ebolavirus outbreak, revealing that 59.4% expressed willingness to receive Ebola vaccination. Women who had previously received COVID-19 vaccines showed 32% higher acceptance rates, while those preferring injectable formulations demonstrated 54% greater willingness compared to women open to oral delivery methods. These findings illuminate a complex landscape of maternal vaccine decision-making shaped by recent pandemic experiences and delivery preferences. The moderate acceptance rate represents both progress and challenge - significantly higher than historical hesitancy toward experimental vaccines during pregnancy, yet insufficient for optimal herd immunity. The COVID-19 vaccination correlation suggests that positive vaccine experiences build confidence for future immunizations, even during vulnerable reproductive periods. However, the preference for injectable over oral formulations contradicts assumptions about convenience-driven choices in resource-limited settings. This research provides crucial baseline data as next-generation Ebola vaccines undergo development with potential pregnancy safety profiles. The 40% hesitancy rate underscores the need for targeted communication strategies addressing safety concerns specific to maternal and fetal outcomes, particularly given the devastating consequences of Ebola infection during pregnancy.