• Emilia Prospero, Sara Galmozzi, Valentina Paris, Gessica Felici, Pamela Barbadoro, Antonella D'Alleva, Gemma Zocco, and Andrea Ciavattini.
• Department of Biomedical Sciences, Section of Hygiene, Università Politecnica delle Marche, Ancona, Italy.
• Influenza Other Respi Viruses. 2019 Mar 1; 13 (2): 201-207.

BackgroundPregnant women are at increased risk of influenza complications. Influenza vaccine provides them a substantial protection.ObjectiveThe aim of this study was to investigate determinants associated with non-adherence to influenza vaccine recommendations in pregnant women in Italy.MethodsA cross-sectional study has been carried out among pregnant women attending their follow-up visit in some mother and child services in a Region of Italy from October 2016 to January 2017. The study protocol was approved by the local research Ethics. A self-administered close-ended questionnaire has been administered to the pregnant women. Differences in background, socio-demographic characteristics, knowledge and attitudes towards flu vaccine were tested in vaccinated and unvaccinated women. Multivariate analysis was performed to control for confounding factors.ResultsThree hundred and sixty-six women answered the survey (97% response rate) and 96.1% (348) declared of being unvaccinated against influenza during the 2016-2017 influenza season. Frequent reasons for refusing vaccination were drugs objection and concerns about vaccines' effects. According to the refusal attitude, influenza knowledge was low in the group. Moreover, analysis showed that low adherence to vaccination is associated to lacking promotion of vaccination to pregnant women carried out by healthcare workers (P < 0.005).ConclusionsHealthcare workers have a key role in assisting women during the gestational period, so their active involvement in vaccination promotion is essential. It is necessary to improve health care workers' knowledge about vaccine relevance in protecting pregnancy and their communication skills to properly inform pregnant women.© 2018 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

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