Acceptance of recommended vaccinations during pregnancy: a cross-sectional study in Southern Italy

Abstract

BackgroundVaccine administration is a recommended, safe, and effective measure to protect pregnant women against vaccine-preventable diseases (VPDs). Despite available guidance, maternal immunization rates for vaccination against influenza and with the reduced antigen content tetanus-diphtheria-acellular pertussis vaccine (Tdap) in Italy remain incredibly low. The primary goal of the study was to explore what Italian pregnant women knew about VPDs and immunization during pregnancy and what factors affected their decision to be vaccinated.MethodsThis cross-sectional study took place between October 2021 and April 2022 in the Southern part of Italy. All consecutive pregnant women, from those attending the selected facilities on randomly selected days, were approached to request participation. The inclusion criteria for participation were age ≥18 years, the ability to understand, speak, and read Italian, and being pregnant at any gestational age. The questionnaire, using a combination of checkboxes and free text answers, consisted of 32 items divided into five parts and lasted ~10 min.ResultsThe results showed that 61% knew that the influenza vaccine is recommended and 48.7% knew that influenza could be risky during pregnancy; 74.1% wrongly reported that the Measles-Mumps-Rubella (MMR) vaccine is recommended during pregnancy. Seven out of 10 pregnant women believed that strong evidence supported the safety of vaccinations during pregnancy, and more than half (55.6%) thought they were at increased risk of severe illness with COVID-19. Women in the sample believed that vaccines received during pregnancy pose a risk of adverse events to the unborn child with a median value of 6 (IQR 3–9), on a scale ranging from 1 to 10. Similarly, the fear of contracting pertussis and influenza during pregnancy showed a median value of 6 (IQR 3–9) and 5 (IQR 3–8), respectively. Only 21.1% and 36.5% of women received influenza and Tdap vaccines during pregnancy.ConclusionUnrealistic risk perception with a negative attitude toward vaccines in pregnancy and a low percentage of vaccinated pregnant women confirm the urgency of training women to make informed choices to increase overall vaccine uptake.

Factors Associated With Influenza Vaccination During Pregnancy: A Real-World Evidence-Based Study

“… 16 , 25 - 27 Despite previous studies have confirmed that vaccination is the safest and most effective method for preventing flu, 3 - 5 concerns about serious vaccine-related side effects and underestimating the risks of severe adverse outcomes during pregnancy still contribute to vaccine hesitancy, in turn, leads to reluctance in getting vaccinated. 28 - 31 A cross-sectional multicenter study in Italy assessed pregnant women’s knowledge, beliefs, and misconceptions about vaccines. The study results showed that only 9% of women completely believed in the safety of vaccinations and almost 20% of women had misconceptions or lack of knowledge about flu vaccinations during pregnancy.…”

“…The study found that those who expressed concerns about potential adverse events for the unborn child from vaccine received during pregnancy were significantly less willing to receive the influenza vaccine (OR = 0.76). 30 From the aforementioned literatures, it is evident that unrealistic perceptions of risk can be associated with barriers that might influence the decision to vaccinate. Therefore, training women to trust accurate healthcare professional information and advice is crucial for making informed choices and increasing vaccine uptake.…”

“…Therefore, training women to trust accurate healthcare professional information and advice is crucial for making informed choices and increasing vaccine uptake. 28 - 31 …”

Burden of delayed discharge on acute hospital medical wards: A retrospective ecological study in Rome, Italy

“…Evolving population knowledge, attitude, and perception of vaccination effects also played a role, as positive intention in vaccination meant a higher vaccine coverage in the following months, and therefore impacted on COVID management [ 64 , 65 ]. As is known, vaccine hesitancy played an important role in COVID, even more than what is expected for other type of pathogens; such behavior impacts on disease spread and consequent drug prescription attitudes on the territory, and this all has a foreseeable impact on hospital demand [ 66 – 68 ]. In particular, antibiotic over prescription (by all types of health personnel) is constantly been linked with the occurrence of antimicrobial resistance, and thus with more difficulties in patient care management and further hospitalization increase [ 69 – 72 ].…”

The power of phages: revolutionizing cancer treatment

“…The cost of research and development, manufacturing, quality control, and distribution can contribute to the high prices associated with certain vaccines. This can limit accessibility, particularly for marginalized communities or countries with limited healthcare resources ( 109 ). In addition, while vaccines generally elicit robust immune responses, there can be instances where the immune response is not as strong as desired.…”