Knowledge attitude and practice toward pertussis vaccination during pregnancy among pregnant and postpartum Italian women

Abstract

In Italy, no specific recommendation toward maternal pertussis immunization during pregnancy has been issued. However, vaccination during pregnancy will be likely integrated in the Italian immunization program in the future. In order to identify barriers to achieving a sufficient vaccination coverage during pregnancy, we investigated knowledge, attitude and practice toward pertussis vaccination during pregnancy through a web-based survey. A total of 343 Italian pregnant women (N = 164) and women in the postpartum period (N = 183) completed the online questionnaire.

More than a half of the study population was uncertain regarding the benefits of the vaccination during pregnancy. Only 1.7% of women in the postpartum had received the vaccination during pregnancy, and 21% of pregnant women declared the intention to be vaccinated in pregnancy. Only 34% would accept the vaccination in the current or in a future pregnancy, if recommended by a physician, and a half would remain uncertain. Perceiving the vaccine as harmful for the fetus’ development is associated to a decreased willingness to be vaccinated if recommended by a HCP, both in pregnant women (OR 0.25 p = 0.010 95% CI 0.09-0.72) and in women in the postpartum period (OR 0.32 p =  0.006 95% CI 0.15-0.72). Our study suggests that the vaccination recommendation by physicians might not be sufficient to adequately raise vaccination coverage against pertussis among Italian pregnant women. A combination of educational interventions and tailored communi-cation campaigns could be implemented to promote maternal immunization.

Keywords:

• maternal immunization
• Maternal-Child Health Services
• Pertussis
• pregnancy
• Tetanus-diphtheria-acellular pertussis vaccine
• vaccination
• vaccine attitudes
• vaccines in pregnancy
• vaccines obstetrics

Abbreviations

Tdap	=	Tetanus-diphtheria-acellular-pertussis
HCPs	=	Healthcare professionals

Disclosure of potential conflicts of interest

All authors declare that they have no financial and personal competing interests.

Acknowledgments

The authors acknowledge Bambino Gesù Children Hospital, nostrofiglio.it and periodofertile.it for promoting and hosting the study. Authors also thank all women whose participation made this study possible.

Authors’ contributions

EA coordinated the study, designed the study and participated in the writing process and data review. FG drafted the manuscript. LA, ADA, EP, IC, LR, BF revised the final version of the manuscript. EC performed the statistical analysis. AET conceived the study, participated in its design and coordination and drafted the manuscript. All authors read and approved the final manuscript.