Knowledge attitudes and practices toward seasonal influenza vaccine among pregnant women during the 2018/2019 influenza season in Tunisia

Abstract

Background The uptake and acceptance of the influenza vaccine (IV) among pregnant women remain unknown in Tunisia despite the increased influenza-related complications and death. The present study aimed to assess the IV uptake and acceptability and to describe related knowledge and attitudes among pregnant women in Tunisia. Methods A cross-sectional study was conducted in 84 Tunisian healthcare facilities over a period of three months (from March to May 2019). All pregnant women aged ≥18 years who sought antenatal care in related health structures were included in this study based on a multistage self-weighted sampling. We measured knowledge and attitudes towards the IV and assessed factors related to willingness for its uptake. Results The questionnaire was completed by 1157 pregnant women. More than half of the participants (60.2%; 95% confidence interval [CI] [57.3%–63.0%]) reported awareness about the IV. Among included PW, only 4.6%; 95% CI [3.5%–6.1%] received it during their current pregnancy. However, (36.8%; 95% CI [34.0%–39.6%]) declared their willingness to receive the vaccine in the next pregnancy. Recommendation by healthcare providers, identified to be the most trustful source of information, was the main reason for acceptance. However, the intention to accept the IV by pregnant women was significantly associated with such recommendation and perceived safety and effectiveness of this vaccine. Conclusion Antenatal care visits are a precious opportunity that should not be missed by health care providers and especially gynecologists to promote the IV uptake by pregnant women in Tunisia.

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

“…A higher coverage has been observed in developed countries such as Japan with a value of 82.1% ( 26 ), Canada with 48.2% ( 27 ), New Zealand with 44% ( 28 ), whereas lower values of 20.8, 18.1, 10.5, and 1.2% have been found respectively in Israel ( 29 ), in Norway and Sweden ( 30 ), in the United Kingdom ( 8 ) and in Germany ( 31 ). Interestingly, very low uptake also of other recommended vaccines among pregnant women have been reported in the literature, including for example results from Italy with none having received tetanus, diphtheria, and acellular pertussis vaccine, and only 1.4% for influenza ( 32 ), and from Tunisia, France, United States, and Peru respectively with 4.6% ( 33 ), 7.4% ( 34 ), 10.3% ( 35 ), and 19% ( 36 ) for influenza. These findings underline the need to promote education intervention, especially during pregnancy, in order to improve women's knowledge on the benefits of antenatal recommended vaccinations.…”

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

“…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.…”

Influenza vaccine uptake in Tunisia from two high-risk groups’ perception and attitudes: a qualitative study

“…This stresses the crucial role of health professionals as a driving force for vaccination; their recommendation was the main reason for vaccine acceptance among both PW and ECD in the quantitative studies part of this project ( 15 , 16 ).…”