Knowledge and acceptance of influenza and pertussis vaccinations among pregnant women of low socioeconomic status in Turkey

Abstract

Pregnant women and infants are at relatively high risk for influenza-and pertussis-related morbidity and mortality. Vaccination is the most important prevention strategy for both diseases. We evaluated knowledge and acceptance of influenza and pertussis vaccinations among pregnant women. We performed a cross-sectional survey of 465 pregnant women receiving prenatal care at the obstetric outpatient clinic in a tertiary medical center in Turkey between November 2015 and May 2016. We used a questionnaire investigating the knowledge of pertussis and influenza to evaluate potential influences on the acceptance or rejection of pertussis or influenza vaccinations. The acceptance rates of pertussis and influenza vaccinations were 11.2% and 19.8%, respectively. Maternal age, education level, employment status, number of gestations, and gestational age did not affect the rate of acceptance of these vaccinations. On the other hand, pregnant women who had a history of vaccination during their adolescence and in previous pregnancies were significantly more likely to accept pertussis vaccination. Knowledge about the risks of pertussis and influenza diseases for pregnant women and their children has a significant effect on vaccination acceptance. Even in low socioeconomic status groups, a recommendation for vaccinations by the primary obstetrician was significantly predictive of acceptance of both pertussis and influenza vaccination. This study revealed that the acceptance rates of pertussis and influenza vaccination among pregnant women are very low in Turkey. Healthcare worker recommendations and increased awareness about pertussis and influenza morbidity and mortality in pregnant women and infants are essential to improve the rates of vaccination acceptance during pregnancy.

Understanding factors that influence the decision to be vaccinated against influenza and pertussis in pregnancy: A qualitative study

“…In terms of health professionals, as shown in numerous studies, our findings identify their recommendation as the most important aspect for pregnant women's decision to be vaccinated (Agricola et al, 2016;Lutz et al, 2018;O'Shea et al, 2018;Vilca et al, 2020) or at least among the main ones (Strassberg et al, 2018;Wales et al, 2020;Yakut et al, 2020). The actions of the nurse-midwifeinforming and/or recommending-were crucial in our study for participants' decision-making, although these actions were perceived differently depending on the vaccine.…”

“…It seems, therefore, that pregnant women value protecting their newborn more than protecting themselves, and they feel an anticipated regret at the thought of something bad happening to their newborn because they did not get vaccinated (Maisa et al, 2018). Pregnant women are more likely to agree to be vaccinated when they understand that influenza and pertussis are risky for both the pregnant woman and the newborn and when they know that maternal vaccination protects the newborn (Yakut et al, 2020). For this reason, it is essential to increase pregnant women's perception of risk and offer them more information that positions the newborn as the main beneficiary of vaccination (Rodríguez‐Blanco et al, 2019; Wilcox et al, 2018; Wiley et al, 2015).…”

Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review

“…Additionally, another study in Tempelhof and Neukölln refugee camps in Germany with parents who reported their children’s fully immunised status from memory (<5 years (28%), ≥5 years (74%), p = 0.005), showed that these parents had more years of education on average with p -values of <0.05 [ 85 ]. Although not statistically significant, in contrast, one study reported that people with elementary to high school education level were less inclined to accept influenza vaccination [ 80 ].…”

Gebelerin Mevsimsel İnfluenza Aşısı ile İlgili Bilgi, Tutum ve Davranışları

“…Ülkemizde 2009 influenza pandemisini takiben yapılan 198 gebenin katıldığı bir çalışmada, katılımcıların sırasıyla yalnızca %3'ünün ve %9,1'inin mevsimsel influenzaya ve pandemik suş olan İnfluenza A(H1N1) suşuna karşı aşı olduğu belirtilmiştir (27). Boğmaca ve influenza aşılarının gebelerce kabul edilme oranının araştırıldığı bir başka çalışmada ise, bu oran boğmaca aşısı için %11,2, influenza aşısı için %19,8 olarak tespit edilmiştir (28). Bu düşük aşılanma oranlarının nedenlerini belirlemek ve bu konuda daha iyi stratejiler geliştirerek gebelikte aşılanma oranlarını artırmak gerekmektedir.…”

“…Bizim çalışmamızda kendisine gebelikte influenza aşısı önerilen katılımcıların 16'sına bu öneri bir aile hekimi ve yalnızca 1'ine bir kadın hastalıkları ve doğum uzmanı tarafından yapılmıştı. Aşı kabul oranlarını artırmaya yönelik çalışmalarda sağlık personeli tarafından eğitim materyalleri aracılığıyla tatmin edici bilgiler verilmesinin etkili olduğu görülmüştür (27,28,30).…”