Vaccination coverage during pregnancy and factors associated with refusal of recommended vaccinations: An Italian cross sectional study

Viola Seravalli · Irene Romualdi · Oumaïma Ammar · Chiara De Blasi · Sara Boccalini · Angela Bechini +1 more

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Vaccine Coverage and Hesitancy Cervical Cancer and HPV Research Intramuscular injections and effects

Abstract

Background: The vaccines recommended during pregnancy are the Tdap, the influenza vaccine, and, during the SARS-CoV-2 pandemic, the vaccine against COVID-19. This survey aimed at determining vaccination coverage among pregnant women and adverse events, reasons for vaccine refusal, and factors associated with vaccine uptake. Methods: A single-center cross-sectional study was conducted on women who delivered between March and April 2022 at Careggi University Hospital in Florence, Italy. Information on the vaccinations (Tdap, influenza and COVID-19) received during pregnancy were collected through in-person interviews. Results: Among 307 enrolled women (response rate 99 % on a study population of 310 eligible women), 74 % of patients were vaccinated with Tdap, 82 % against COVID-19, and only 33 % against influenza. Vaccination coverage for Tdap and COVID-19 was significantly higher among Italian than foreign patients (80 % vs 51 %, p < 0.001 and 86 % vs 69 %, p = 0.002, respectively), and for Tdap was higher among patients followed in the private vs public care setting. The main reasons behind refusal of vaccinations were low risk perception of influenza (41 %), insufficient information received from the prenatal care provider regarding the Tdap (35 %), and, for the COVID-19, fear of vaccine side effects (64 %), and concerns about effects on the fetus (70 %). Conclusions: Adherence to the influenza vaccine was low because of reduced perception of the disease risks. The difference in vaccination coverage between Italians and foreigners is an example of healthcare disparity. Better information provided to patients about vaccines' efficacy and safety is advisable to increase acceptance of recommended vaccines.

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2004Agreement of Self-Reported Medical History: Comparison of an In-Person Interview with a Self-Administered Questionnaire 2020Influenza and Tdap Vaccination Coverage Among Pregnant Women — United States, April 2020 2015Influenza Vaccination Coverage Among Pregnant Women — United States, 2014–15 Influenza Season 2018Vaccination knowledge and acceptability among pregnant women in Italy 2023Influenza, Tdap, and COVID-19 Vaccination Coverage and Hesitancy Among Pregnant Women — United States, April 2023 2021Vaccines - safety in pregnancy 2019Vital Signs: Burden and Prevention of Influenza and Pertussis Among Pregnant Women and Infants — United States 2017Seasonal influenza vaccination in pregnant women: knowledge, attitudes, and behaviors in Italy

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