COVID-19 vaccination hesitancy and willingness among pregnant women in Italy

Abstract

BackgroundPregnant women, especially those with comorbidities, compared to those non-pregnant, have higher risk of developing a severe form of COVID-19. However, COVID-19 vaccine uptake is very low among them.MethodsAn anonymous questionnaire was administered to randomly selected women 18 years of age that were currently pregnant or had just given birth between September 2021 and May 2022 in the geographic area of Naples. Vaccine hesitancy was assessed using the vaccine hesitancy scale (VHS).ResultsA total of 385 women participated. Women who had not been infected by SARS-CoV-2 and who needed information about vaccination against COVID-19 had a higher perceived risk of being infected with SARS-CoV-2. More than half (54.3%) of the women were very afraid of the potential side effects of the COVID-19 vaccination on the fetus. There was higher concern of the side effects of the vaccine on the fetus among those who did not have a graduate degree, those with high-risk pregnancy, those who had not been infected by SARS-CoV-2, those who were more concerned that they could be infected by SARS-CoV-2, those who did not know that this vaccination was recommended for them, and those trusting mass media/internet/social networks for information. Only 21.3% were vaccinated when pregnant, mostly women with a university degree, those who had been infected by SARS-CoV-2 before pregnancy, those who did not need information, and those who acquired information about the vaccination from gynecologists. Almost three-quarters (71.9%) were willing to receive the vaccination and those more likely were those with a university degree, those who have had at least one relative/cohabitant partner/friend who had been infected by SARS-CoV-2, those who were more concerned that they could be infected by SARS-CoV-2, and those who were not extremely concerned of the side effects of the vaccine on the fetus. A total of 86.4% were highly hesitant. Highly hesitant were respondents who did not get a graduate degree, those less concerned that they could be infected by SARS-CoV-2, and those trusting mass media/internet/social networks for information.ConclusionPublic health efforts and education campaigns for pregnant women are needed for changing their perception patterns and for supporting gynecologists in promoting the uptake of this vaccination.

Midwives’ Knowledge, Attitudes, and Practice Regarding COVID-19 Vaccination for Pregnant Women: A Nationwide Web-Based Survey in Italy

“…These finding are unexpected and disappointing as the severity of COVID-19 is well proven [ 1 , 2 , 3 , 4 ] and there is a large amount of data supporting the benefits and safety of this vaccination [ 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. However, similar concerns have been reported in other studies among pregnant women [ 14 , 34 , 35 , 36 , 40 ] and midwives [ 41 ]. Thus, the COVID-19 vaccination coverage among pregnant women may be enhanced by education interventions targeted to midwives to improve their awareness of the clinical burden of the disease and to address their concerns about this vaccination.…”

“…Moreover, midwives with more years of activity and those who have never provided assistance to a pregnant infected by SARS-CoV-2 had a positive influence in providing information regarding the vaccination. This last result is unexpected, as studies among other groups found that those who knew someone infected were more willing to receive the COVID-19 vaccination [ 14 , 26 , 42 ]. Furthermore, midwives who considered the COVID-19 vaccination useful for pregnant women were more likely to always recommend it.…”

“…This value was higher than the 37.5% in a sample of midwives in France [ 20 ]. As indicated in other surveys, a HCW’s recommendation has been shown to be one of the main factors influencing individual’s perceptions and practices about vaccinations [ 14 , 34 , 35 , 36 ] and the lack of a recommendation is often a reason for not being immunized [ 14 , 37 , 38 , 39 ]. Understanding the barriers is necessary for developing interventions that could increase the vaccination coverage.…”

“…Although none of the initial vaccine trials enrolled pregnant women, now there is extensive real-world evidence confirming the vaccine’s safety [ 6 , 7 , 8 , 9 ] and effectiveness in pregnancy [ 10 , 11 , 12 ]. However, the vaccination coverage rate remains unsatisfactory in most countries among this group [ 13 , 14 , 15 , 16 ], as for other recommended vaccines [ 17 , 18 , 19 ], and considerably lower than in the general female population [ 16 ], providing arguments to reinforce the recommendations for the reduction in the overall COVID-19 severity and mortality.…”

Willingness to accept a second COVID-19 vaccination booster dose among healthcare workers in Italy

“…All data were collected through a self-administered questionnaire adopted and modified from previously published studies of the research group (11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The questionnaire required 5-10 min to complete and capture the following information: a) sociodemographic, general, and professional characteristics (14 questions), including gender, age, relationship status, degree of education, professional role, duration of employment in the healthcare profession, area of working activity, self-rated health status, and previous COVID-19 infection; b) source(s) from which they receive information related to the second booster dose and whether they would like to get additional information (2 questions); and c) attitudes and behaviors (7 questions).…”