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Knowledge and Attitudes regarding influenza vaccination among pregnant women in Tunisia

Sonia Dhaouadi

Vaccination coverage among expectants remains suboptimal worldwide. To achieve a successful vaccination program, it is essential to understand reasons behind the acceptance of vaccination or its rejection. The present study aimed to describe knowledge and attitudes related to flu vaccine during pregnancy among Tunisian women. A national survey type Knowledge, and Attitudes was conducted during the 2018-19 flu season using a self-weighted two stages sampling method. Data were collected through face-to-face interviews with pregnant women present at the obstetrics outpatient consultations of the selected primary or secondary health care facilities. A total of 1157 pregnant women agreed to be interviewed. More than half of participants (60.3%) had heard about the influenza vaccine before. Among them, only 75 (10.9%) declared that they had enough information about safety and side effects of influenza vaccine. When asked about flu vaccine safety, most than half disagreed with those statements in disfavor of vaccine during pregnancy: the vaccine can be dangerous for pregnant women (62.2%), for the fetus (64.7%), for the newborn (66.7%) and can cause the flu (82.5%).  Whereas, less than half were in agreement with those statements in favor of influenza vaccine effectiveness: flu vaccination of pregnant women helps to protect the mother (47.8%), the fetus (36.0%) and the unborn child (34.2%) against influenza.

In addition, 36.5% reported a positive willingness to receive the flu vaccine during pregnancy. Vaccine recommendation from healthcare workers was reported as the most important reason for vaccine acceptance and Health care workers were identified as the most trusted source of information about influenza immunization. Health care workers, especially midwifes and gynecologists should be aware of the crucial role that they can play to increase knowledge and positive attitudes towards safety and effectiveness of the flu vaccine among pregnant women to achieve a high vaccine coverage during pregnancies.