Covid-19 vaccination during pregnancy: A mixed-methods study of attitudes in a sample of Italian women and the role of health professionals’ communication

Objectives: We examined Italian pregnant women’s attitudes about the diphtheria, tetanus, and pertussis (DTP) vaccine, seasonal influenza, and Covid-19 vaccines, healthcare professionals’ (HP) communication, reasons and potential predictors for non-adherence. Methods: From August 2021 to January 2022, we carried out a cross-sectional study in Italy using an online self administered questionnaire addressed to women of age and pregnant, designed using LimeSurvey and dissem inated through social media. Questions explored vaccination attitude/perceptions, satisfaction, and trust in HPs’ information. Thematic analysis of free-text responses was performed using MaxQDA 2022. Statistical analyses were performed using STATA. Results: 1594 responses were obtained. 52% of women hesitated to be vaccinated against Covid-19 while pregnant. Information received by HPs was deemed incomplete by 56% of participants, unclear by 52%, and untrustworthy by 46%; 49% felt unsupported in their decision-making process. This variable was one predictor of vaccine hesitancy together with concern about vaccine safety in the multivariate model. The analysis of open ended questions revealed a pervasive feeling of dissatisfaction. Conclusion: The perceived lack of adequate communication and support by HPs affected pregnant women’s decision-making process on Covid-19 vaccination. Practice implications: HPs need to understand and communicate the importance of vaccination during pregnancy, learning to better tailor their messages.