Department of Health Sciences, School of Medicine, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
Front Public Health. 2023 Jul 6;11:1214459. doi: 10.3389/fpubh.2023.1214459. eCollection 2023.
This study aimed to assess whether Italian healthcare workers (HCWs) recommend the reduced antigen content tetanus-diphtheria-acellular pertussis vaccination (Tdap) to pregnant people, as well as what variables could predict their decision to advise and recommend immunization to pregnant people.
This cross-sectional study took place between August 2021 and June 2022 in a sample of obstetricians-gynecologists, midwives, and primary-care physicians in two regions of Southern Italy. A self-administered questionnaire was used to gather the data.
The results showed 91.3% (379) of participants knew that receiving the Tdap vaccine during pregnancy protects against pertussis in both the expectant person and the newborn before active immunization. Only 68.9% (286) knew that the Tdap vaccination has to be administered during the third trimester of gestation. A small but still significant proportion of participants (14.7%) (61) believed that the potential risks of vaccines administered during pregnancy outweighed the benefits. An improvable proportion of HCWs regularly provided information [71.8% (298)] and recommended [81% (336)] Tdap vaccination to pregnant people. The strongest factors that drove HCWs to inform pregnant people about the Tdap vaccination were to be aware that vaccinating those in close contact with newborns is an effective strategy to prevent pertussis (OR: 2.38; 95% CI: 1.11-5.13) and that the Tdap vaccine is provided only in the third trimester of pregnancy (OR: 1.74; 95% CI: 1.06-2.86). Informing pregnant people about the possibility of receiving the Tdap vaccine during pregnancy (OR: 60.13; 95% CI: 23.50-153.8) was the strongest predictor of having recommended the Tdap vaccination during pregnancy.
Educational and informative interventions to improve HCWs' knowledge about the importance of the Tdap vaccine and their communication skills to properly counsel pregnant people are needed. Beyond vaccine recommendations, how well immunization strategies are implemented in real-world situations impacts vaccination uptake. Therefore, during regular care visits, expecting people must have easy access to vaccines. Prenatal immunizations should become common practice, and there should be no conceptual doubt about vaccinations among HCWs to safeguard pregnant people and their unborn children from vaccine-preventable diseases.
本研究旨在评估意大利医护人员（HCWs）是否会向孕妇推荐低抗原含量的破伤风类毒素-白喉-无细胞百日咳联合疫苗（Tdap），以及哪些变量可以预测他们向孕妇提供建议和推荐免疫接种的决定。
这项横断面研究于 2021 年 8 月至 2022 年 6 月在意大利南部两个地区的产科医生-妇科医生、助产士和初级保健医生中进行。使用自我管理问卷收集数据。
结果显示，91.3%（379）的参与者知道在孕妇怀孕期间接种 Tdap 疫苗可以预防孕妇和新生儿在主动免疫前发生百日咳。只有 68.9%（286）的人知道 Tdap 疫苗必须在妊娠第三个三个月接种。一小部分但仍有意义的参与者（14.7%）（61）认为怀孕期间接种疫苗的潜在风险大于益处。相当比例的 HCWs 定期向孕妇提供信息[71.8%（298）]并建议[81%（336）]接种 Tdap 疫苗。促使 HCWs 向孕妇告知 Tdap 疫苗接种的最强因素是意识到为与新生儿密切接触的人接种疫苗是预防百日咳的有效策略（OR：2.38；95%CI：1.11-5.13），并且 Tdap 疫苗仅在妊娠第三个三个月提供（OR：1.74；95%CI：1.06-2.86）。告知孕妇怀孕期间接种 Tdap 疫苗的可能性（OR：60.13；95%CI：23.50-153.8）是推荐孕妇接种 Tdap 疫苗的最强预测因素。
需要开展教育和信息干预措施，以提高 HCWs 对 Tdap 疫苗重要性的认识，并提高他们向孕妇提供适当咨询的沟通技巧。除了疫苗推荐外，免疫策略在实际情况中的实施情况如何也会影响疫苗接种率。因此，在常规护理就诊期间，孕妇应方便获得疫苗。产前免疫应成为常规做法，HCWs 不应在疫苗接种问题上存在概念性疑虑，以保护孕妇及其未出生的孩子免受可通过疫苗预防的疾病的侵害。
