Knowledge, Attitude, Perceptions, and Concerns of Pregnant Women Regarding the Influenza Vaccination in Kocaeli, Turkey

Abstract

Introduction In order to better understand the barriers to influenza vaccination, we have designed a study to investigate pregnant women's knowledge, attitude, perceptions, and concerns towards the inactivated influenza vaccine. Materials and methods In this prospective study, carried out between July 1, 2019, and December 31, 2019, 252 pregnant women (≥12 weeks of gestational age), who had consented to be enrolled in the study, were asked to complete an interviewer-administered questionnaire during their stay in the hospital ward. Results The lack of information about influenza vaccines (59.4%) was in the first rank among the reasons for personal and parental vaccine rejection. Most (65.1%) pregnant women either did not believe in or had doubts about the efficiency of the influenza vaccine during gestation. Most of them (80.9%) either were not sure about or did not have much confidence in the prenatally inoculated vaccine's ability to protect their babies postnatally. Some (25.6%) participants attributed their vaccinal unwillingness to fear of adverse effects, and some (11.5%) deemed gestational influenza immunization unnecessary because of their tendency to underestimate the grave consequences of influenza contracted by infants within the first six months of life. The higher the education level, the higher was the knowledge of and the willingness to be immunized against influenza. Discussion It is known that about one-third of pregnant women in Turkey have never heard of the influenza vaccine. Unawareness of influenza vaccination in pregnancy is significantly related to vaccine uptake in Japan. Patient education on knowledge of influenza and influenza vaccination has a booster effect on vaccination rates. Had the influenza vaccine been routinely administered to pregnant women in Turkey, the lives of the majority of the women who died of influenza in the influenza A (H1N1) pandemic in 2009 would have been saved. Low-risk perception is quoted as one of the main reasons for influenza vaccine refusal during pregnancy, which was also the case in our study. Concordant with the current literature, the education level and household income were correlated with the level of influenza vaccination uptake. Pregnant women's fear of adverse effects of the influenza vaccine might extend to the fear of birth defects. Conclusion The acceptance of influenza vaccines by pregnant women is a consequence of complex interactions of various factors. Giving necessary information to pregnant women is one of the most important factors that can increase influenza vaccine uptake. For this reason, it should be ensured that the efficacy and safety data of the influenza vaccine are more widely included in vocational training activities of health personnel and in prenatal care textbooks and guidelines.

Keywords: child; influenza; pregnancy; pregnant women; turkey; vaccination hesitancy; vaccination refusal; vaccines.