Department of Health Sciences, School of Medicine, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
Front Public Health. 2023 May 12;11:1132751. doi: 10.3389/fpubh.2023.1132751. eCollection 2023.
Vaccine 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.
This 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.
The 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.
Unrealistic 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.
疫苗接种是保护孕妇免受疫苗可预防疾病（VPD）的推荐、安全且有效的措施。尽管有相关指南，但意大利的流感疫苗和含低抗原含量的破伤风、白喉、无细胞百日咳疫苗（Tdap）的孕产妇免疫接种率仍低得令人难以置信。该研究的主要目标是探讨意大利孕妇对 VPD 和妊娠期间免疫接种的了解程度，以及哪些因素影响了她们接种疫苗的决定。
这是一项横断面研究，于 2021 年 10 月至 2022 年 4 月在意大利南部进行。所有连续的孕妇，只要她们在选定的设施中在随机选定的日子就诊，都被邀请参加。参与的纳入标准为年龄≥18 岁，能够理解、说和读意大利语，且处于任何妊娠阶段。问卷采用复选框和自由文本答案相结合的方式，共 32 个项目，分为五个部分，持续约 10 分钟。
结果显示，61%的孕妇知道流感疫苗是推荐接种的，48.7%的孕妇知道流感在怀孕期间可能有风险；74.1%的孕妇错误地报告麻疹、腮腺炎、风疹（MMR）疫苗在怀孕期间是推荐接种的。十分之七的孕妇认为有强有力的证据支持怀孕期间疫苗接种的安全性，超过一半（55.6%）的孕妇认为她们感染 COVID-19 后病重的风险增加。样本中的孕妇认为怀孕期间接种的疫苗对胎儿有不良事件的风险，中位数为 6（IQR 3-9），分值范围为 1 到 10。同样，孕妇对怀孕期间感染百日咳和流感的恐惧也分别显示出 6（IQR 3-9）和 5（IQR 3-8）的中位数。只有 21.1%和 36.5%的孕妇在怀孕期间接种了流感和 Tdap 疫苗。
对疫苗的不切实际的风险认知、对怀孕期间疫苗接种的消极态度以及低比例的孕妇接种疫苗，证实了培训孕妇做出知情选择以提高整体疫苗接种率的紧迫性。
