COVID-19 in Pregnancy: Knowledge about the Vaccine and the Effect of the Virus. Reliability and Results of the MAMA-19 Questionnaire

Abstract

Background: Fear or mistrust of the vaccine and concern for the well-being of their unborn infants are the main reasons for COVID-19 vaccine hesitancy in pregnant women. The aim of this work was to validate a questionnaire on knowledge about COVID-19 vaccination during pregnancy and to examine the sources of information in a group of new mothers, as well as their effectiveness and intelligibility. Methods: A literature review was carried out to develop a questionnaire of forty-five questions, divided into six sections, called MAMA-19. The assessment of agreement and the interrater reliability was carried out using Cronbach’s analysis and Cohen’s kappa statistic. Data obtained from the questionnaire were analysed using descriptive and univariate statistics. Results: The total alpha values in the two sections about knowledge of vaccination during pregnancy and about the effects of disease and possible post-COVID-19 consequences for the unvaccinated showed sufficient consistency, at 0.860 and 0.725, respectively. Non-vaccinated women thought that receiving the COVID-19 vaccine during pregnancy can lead to malformations in the newborn (60% vs. 40%, p = 0.002) and to an increased risk of foetal growth restriction (61.9% vs. 38.1%, p < 0.001). The percentage of vaccinated women was significantly higher than non-vaccinated when more than one professional was consulted and consistent information was received from them (74.2% vs. 25.8%, p = 0.008). Conclusion: The MAMA-19 questionnaire shows results in line with the literature and valid in the two main sections. It is quick to use for measuring communication effectiveness by healthcare professionals and institutions in the context of the COVID-19 vaccination campaign in the pregnant population. The results evidence that a physician’s recommendation to get vaccinated is the most important factor in maternal decision making, regardless of geographic, social or educational context.

Knowledge, Propensity and Hesitancy among Pregnant Women in the Post-Pandemic Phase Regarding COVID-19 Vaccination: A Prevalence Survey in Southern Italy

“…Our study also highlights that women with comorbidities, despite being more vulnerable to disease, have a lower vaccination rate, similar to the data obtained by Snajider et al [24]. We also evaluated the role of information sources related to active immunization and found that HCWs played a large part in the empowerment and adherence of pregnant women with higher vaccination coverage, as indicated in other studies [27].…”

“…Our results show a high vaccination rate, reaching 90%, most likely derived from the distribution of the sample. In fact, we found that educational degree and age had a high impact on the acceptance of vaccination, as indicated by Del Giudice et al [23], and similar to another study, our sample was predominantly composed of people with higher educational attainment compared to those with medium-low instruction levels [24].…”

Determinants of Vaccination and Willingness to Vaccinate against COVID-19 among Pregnant and Postpartum Women during the Third Wave of the Pandemic: A European Multinational Cross-Sectional Survey

“…In a Spanish study conducted among 302 pregnant women and 309 healthcare workers investigating factors acting as major decision makers for receiving a vaccination, a recommendation from healthcare workers was the most pivotal influence for pregnant women, with 73% naming it as an influencing factor [ 33 ]. An Italian survey revealed that a physician’s recommendation to be vaccinated against COVID-19 is the most important factor in maternal decision making, regardless of geographic, social, or educational context [ 34 ]. Similarly, in the previously mentioned French survey performed in Spring 2021, pregnant women who received information from a healthcare provider (HCP) were more likely to accept vaccination [ 32 ].…”