Impact Assessment of an Education Course on Vaccinations in a Population of Pregnant Women: A Pilot Study

"Hesitancy finds its roots in the absence of accurate information."

Misinformation shared through the internet and other means has led to mistrust and hesitancy about vaccination in pregnancy, which indicates that the media play a role in channelling health-related information and that they affect parents' decisions about having their children vaccinated. During pregnancy and after the birth, the territorial healthcare service accompanies the expectant mother/couple, providing support and ensuring the continuity of care; information to encourage vaccination can be provided in this context. The aim of this study was to evaluate pregnant women's knowledge of and attitudes towards vaccination, their sources of information on vaccination, and the impact of an educational intervention carried out by experts on vaccination.

The 30-minute intervention on vaccine prevention was undertaken at the Obstetrics and Gynaecology Department of the Careggi University Hospital in Florence, Italy. The intervention was supported by the use of a set of slides, the paper version of which was then distributed to each participant. The topics covered were: what a vaccine is; how a vaccine works; the "herd immunity" effect; vaccine contraindications and risks; the National Plan for Vaccine Prevention (PNPV) 2017-2019; the success of vaccines; recent epidemics; false myths; vaccines during pregnancy; the law on obligatory vaccinations; and advice on how to obtain correct information.

To assess the impact of the course on the knowledge and attitudes of future mothers on vaccination, 214 pregnant women completed anonymous questionnaires before and after the intervention. A descriptive and statistical analysis was carried out.

The most common sources of information about vaccination were word of mouth (friends, family, etc.) (50%), the family doctor (45.7%), traditional mass media (TV, radio, newspapers) (35.7%), and institutional websites (19.5%). Paediatricians and gynaecologists were sources of information in 21.4% and 16.2% of cases, respectively. During the pre-intervention phase, the quality of the information received from health professionals was judged to be excellent (9%), good (31%), sufficient (31%), insufficient (17%), and scarce (11%).

The sample population was initially not hostile to vaccines, albeit poorly or insufficiently informed (43%). The educational intervention had a positive impact, especially as a vaccine information tool and for addressing vaccine hesitancy. Notably, after the intervention, the percentage of women who considered their level of knowledge about vaccines to be poor or insufficient was reduced by 30%. The average score on the items concerning the women's intention to be vaccinated during pregnancy and to have their children vaccinated was 35.46 before the intervention and 42.57 after the intervention.

The researchers say that "respondents' answers to the question concerning mandatory vaccination for school attendance confirm that providing correct information reduces maternal vaccination hesitancy, encouraging subjects to adopt a provaccination stance; however, it does not significantly influence the no-vaccine position." Citing literature on classification of parents into categories of pro-vaccination, hesitant, and anti-vaccination, the researchers stress that it is important to know the characteristics of the individual categories, as this knowledge can help to guide appropriate educational programmes.

In conclusion: "Training health professionals and providing...information on vaccinations, in line with national recommendations, are crucial, in order to respond to the concerns of...parents. Indeed, health professionals need to identify what drives parents' decisions concerning the vaccination of their children, in order to communicate more effectively with them....Educational interventions held during pregnancy, when women are more receptive, may have a highly positive impact on lifetime attitudes towards vaccination."