Pregnancy vaccination predictive factors and uptake profiles among Italian women: A cross-sectional survey study on a large population

ObjectivesTo assess influenza and Tdap (tetanus, diphtheria, pertussis) vaccine coverage during pregnancy, explore key socioeconomic and maternity pathway-related predictors of vaccination, and detect specific patterns of vaccination uptake. MethodsThe authors cross-sectionally analyzed self-reported data obtained from the systematic survey on the maternity pathways of Tuscany. They selected all pregnant women that completed from March 2019 to June 2022 the third-trimester questionnaire (n = 25 160), which included two dichotomous items on influenza and Tdap vaccination, as well as socioeconomic and pathway-related questions. Multilevel logistic models were performed to assess vaccination predictors and cluster analysis to identify vaccination patterns. ResultsVaccination coverage was higher for pertussis (56.5%) than for influenza (18.9%). The main predictors of vaccination were high socioeconomic status, attending private gynecologists, and receiving vaccine information. Three clusters were identified: cluster 1 included women receiving both Tdap and influenza vaccines; cluster 2 included women receiving no vaccinations; and cluster 3 included women receiving only the pertussis vaccine. Although women from cluster 3 were of middle to low education status, vaccine information was the main adherence determinant also in this group. ConclusionsHealth workers and policymakers should focus on groups of pregnant women less prone to vaccination to promote vaccination information and encourage wider uptake and coverage.

Automated summary

This study aims to assess the coverage of influenza and Tdap vaccines during pregnancy, explore predictors of vaccination related to socioeconomic and maternity pathways, and identify specific patterns of vaccination uptake. The results showed that pertussis vaccine had a higher coverage than influenza vaccine. High socioeconomic status, attending private gynecologists, and receiving vaccine information were the main predictors of vaccination. Three vaccination clusters were identified, and it is recommended that health workers and policymakers focus on pregnant women who are less likely to be vaccinated to promote vaccine information and encourage wider uptake.