Knowledge and attitudes on pediatric vaccinations and intention to vaccinate in a sample of pregnant women from the City of Rome

Annalisa Rosso; Azzurra Massimi; Corrado De Vito; Giovanna Adamo; Valentina Baccolini; Carolina Marzuillo; Maria Rosaria Vacchio; Paolo Villari

doi:10.1016/j.vaccine.2019.02.049

Knowledge and attitudes on pediatric vaccinations and intention to vaccinate in a sample of pregnant women from the City of Rome

Vaccine. 2019 Mar 28;37(14):1954-1963. doi: 10.1016/j.vaccine.2019.02.049. Epub 2019 Feb 28.

Authors

Annalisa Rosso¹, Azzurra Massimi², Corrado De Vito³, Giovanna Adamo⁴, Valentina Baccolini⁵, Carolina Marzuillo⁶, Maria Rosaria Vacchio⁷, Paolo Villari⁸

Affiliations

¹ Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy. Electronic address: annalisa.rosso@uniroma1.it.
² Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy. Electronic address: azzurra.massimi@uniroma1.it.
³ Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy. Electronic address: corrado.devito@uniroma1.it.
⁴ Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy. Electronic address: giovanna.adamo@uniroma1.it.
⁵ Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy. Electronic address: valentina.baccolini@uniroma1.it.
⁶ Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy. Electronic address: carolina.marzuillo@uniroma1.it.
⁷ Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy. Electronic address: rosaria.vacchio@uniroma1.it.
⁸ Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy. Electronic address: paolo.villari@uniroma1.it.

PMID: 30827733
DOI: 10.1016/j.vaccine.2019.02.049

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Attitudes; Knowledge; Pregnancy; Pregnant women; Vaccination; Vaccine hesitancy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Female
Health Knowledge, Attitudes, Practice*
Humans
Patient Acceptance of Health Care*
Pregnant Women* / psychology
Public Health Surveillance
Rome / epidemiology
Surveys and Questionnaires
Vaccination* / adverse effects
Vaccination* / methods
Vaccines / administration & dosage
Vaccines / adverse effects

Substances

Vaccines