Rosso Annalisa, Massimi Azzurra, De Vito Corrado, Adamo Giovanna, Baccolini Valentina, Marzuillo Carolina, Vacchio Maria Rosaria, Villari Paolo
Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy.
Vaccine. 2019 Mar 28;37(14):1954-1963. doi: 10.1016/j.vaccine.2019.02.049. Epub 2019 Feb 28.
In recent years, pediatric immunization rates in Italy have decreased well below the recommended thresholds, largely due to an increase in scepticism about the efficacy and safety of vaccines. We aimed to identify the degree of such scepticism, and the factors driving it, among a sample of pregnant women in the City of Rome.
We conducted a cross-sectional survey on a sample of pregnant women attending antenatal classes (CANs) in Rome through distribution of a self-administered questionnaire. Multiple logistic regression models were built to analyze the determinants of knowledge, attitudes and intention to vaccinate in this population.
A total of 458 pregnant women attending CANs in 36 family health centers and two hospitals in Rome answered the survey. Mean age was 32.9 (±5.0) years, and over 90% of women were in their first pregnancy. More than 26% of respondents showed a good level of knowledge of the safety and efficacy of vaccines, but there were high rates of uncertainty or agreement with some of the most common anti-vaccination sentiments. Only 75% of women were sure about vaccinating their children with the hexavalent vaccine, and 64.3% with MMR. A good level of knowledge was the strongest predictor of positive attitudes towards vaccination (OR 11.61, 95% CI 6.43-20.96), which, in turn, influenced the intention to vaccinate for most vaccines with the perception of the benefit of immunization for protection against disease.
Scepticism about the safety, efficacy and importance of vaccines is associated to pregnant women's hesitancy to vaccinate their children, suggesting the need to develop strategies to increase vaccine acceptance in the antenatal period. The capacity of health care professionals, particularly midwives, to correctly deliver information to future parents should be strengthened in order to reduce the spread of misinformation and fear of vaccine safety.
近年来，意大利的儿童免疫接种率大幅降至推荐阈值以下，主要原因是人们对疫苗的有效性和安全性的怀疑有所增加。我们旨在确定罗马市一部分孕妇中这种怀疑的程度及其驱动因素。
我们通过发放自填式问卷，对在罗马参加产前课程（CANs）的孕妇样本进行了横断面调查。建立了多个逻辑回归模型，以分析该人群中疫苗接种知识、态度和意愿的决定因素。
罗马36个家庭健康中心和两家医院的458名参加CANs的孕妇回答了调查。平均年龄为32.9（±5.0）岁，超过90%的女性为首次怀孕。超过26%的受访者对疫苗的安全性和有效性有较好的了解，但对于一些最常见的反疫苗观点，存在较高比例的不确定或认同情况。只有75%的女性确定会给孩子接种六价疫苗，64.3%的女性确定会接种麻腮风疫苗。良好的知识水平是对疫苗接种持积极态度的最强预测因素（比值比11.61，95%置信区间6.43 - 20.96），而这种积极态度反过来又影响了接种大多数疫苗的意愿，因为人们认识到免疫接种对预防疾病有益。
对疫苗安全性、有效性和重要性的怀疑与孕妇对给孩子接种疫苗的犹豫有关，这表明需要制定策略以提高孕期对疫苗的接受度。应加强医疗保健专业人员，特别是助产士向准父母正确传递信息的能力，以减少错误信息的传播和对疫苗安全性的恐惧。
