Women's attitude towards COVID-19 vaccination in pregnancy: A survey study in northern Italy

Abstract

Objective: To investigate attitudes and risk perceptions towards the coronavirus disease 2019 (COVID-19) vaccine and reasons for hesitancy among pregnant women.

Methods: A prospective survey study was conducted at a University Maternity Department. Participants included any pregnant woman aged 18 years or older, able to understand the Italian language, who accessed the antenatal clinic for a prenatal appointment. The survey comprised questions about sociodemographic characteristics, pregnancy vaccination history, and perception of risk related to the immunization for the woman herself and her infant.

Results: A total of 538 women completed the questionnaire, 445 (82.7%) accepted COVID-19 vaccination. Women vaccinated against pertussis were three times more likely to take up the COVID-19 vaccine (odds ratio [OR] 3.19; 95% confidence interval [CI] 1.78-5.72). Having had COVID-19 during pregnancy (OR 0.24; 95% CI 0.11-0.54), and having a high-risk perception towards the immunization for the fetus (OR 0.18; 95% CI 0.09-0.34) were factors associated with vaccine hesitancy. Lack of safety data in pregnancy and the possibility of harm to the fetus were the main concerns.

Conclusion: A trusting and supportive relationship with the healthcare professional to address fears, and the transmission of evidence-based information, are pivotal to guide women through an informed choice. Understanding the determinants implicated in women's decision making might guide towards effective public health strategies to boost vaccine acceptance.

Keywords: COVID-19 vaccine; SARS-CoV-2; maternal attitude; risk perception; vaccination in pregnancy; vaccine acceptance; vaccine hesitancy.

FIGURE 1

Women's reasons for not taking up the COVID‐19 vaccine.

FIGURE 2

Maternal source of information regarding COVID‐19 vaccine.

FIGURE 3

Distribution of maternal risk perception of the immunization reported by the entire sample compared with the risk perception for the mother herself (Panel a) or for her infant (Panel b), based on COVID‐19 vaccine uptake. The risk perception score on the Likert scale included in the questionnaire ranged from 1 to 5. The blue bars (Panel a) and the orange bars (Panel b) show the score of risk perception of the immunization (1, 2, 3, 4, or 5) reported by the entire sample on the Likert scale for the women themselves and for their infant, respectively. The scores stated by the entire sample are compared with the risk perception indicated by vaccinated and unvaccinated participants for themselves (Panel a) and for their infant (Panel b).