Pregnant Women's Knowledge of and Attitudes towards Influenza Vaccination during the COVID-19 Pandemic in Poland

Immunogenicity of inactivated quadrivalent influenza vaccine in pregnant women, including the level of postvaccination antibodies in umbilical cord blood

BACKGROUND

Infants and pregnant women are particularly vulnerable to severe illness and complications of influenza. It is necessary to increase knowledge about the safety and effectiveness of influenza vaccination during pregnancy to improve awareness among patients and healthcare professionals and increase to increase vaccination coverage.

METHODS

A prospective, single-group clinical study was performed in the 2021/2022 and 2022/2023 seasons. The aim of the study was to assess the immunogenicity and tolerance of quadrivalent influenza vaccine (IIV4) in pregnant women, to evaluate transplacental antibody (AB) transfer after IIV4 administration, and to estimate optimal gestational age for vaccination. A group of 62 pregnant women between 14 and 37 weeks of gestation, including 59 mother-child pairs, underwent vaccination with IIV4. The humoral immune response was assessed using the EMA criteria.

RESULTS

Baseline seroprotection for all IIV4 strains was significantly correlated with previous vaccinations (p < .5). The postvaccination seroprotection ranged between 71 % and 94 %. A significant increase in AB titers was observed for all vaccine strains (p < .0000). No significant differences were observed in seroprotection and seroconversion rates or transplacental AB transfer between women vaccinated in the 2nd vs 3rd trimester of pregnancy. All IIV4 strains used in the study met at least 1 of the 3 EMA/CPMP immunogenicity criteria and may thus be considered immunogenic. Seroprotection for A/H1N1/pdm09, A/H3N2, B/lineage Victoria (B/V), and B/lineage Yamagata (B/Y) antigens was achieved by 97 %, 95 %, 59 %, and 85 % of neonates, respectively. Over 43 % of participants reported solicited injection site reactions. None of the participants reported severe or unsolicited adverse events.

CONCLUSIONS

IIV4 induced a strong immune response in pregnant women and a high rate of seroprotection in neonates. Immune protection in children did not differ according to the trimester of vaccination in pregnancy. IIV4 was well tolerated by pregnant women.

Maternal Vaccination and Neonatal Feeding Strategies Among Polish Women

Background/Objectives: Maternal vaccination and breastfeeding are important aspects of public health that should be recommended by medical staff caring for pregnant and postpartum women. We aimed to analyze factors affecting women's likelihood of dual vaccination during pregnancy and their infant feeding strategies. Methods: A cross-sectional study was conducted with 953 Polish mothers. An online questionnaire was used and included questions on sociodemographic and obstetric variables, women's attitudes towards COVID-19 and influenza vaccination, and breastfeeding practices. Results: COVID-19 vaccination was reported by 66.0%, influenza vaccination by 18.2%, and dual vaccination by 15.6% of Polish mothers. Increasing willingness to receive vaccines was significantly associated with older maternal age, lower BMI, living in urban areas with >100,000 residents, and high levels of knowledge regarding vaccination. No significant association between dual vaccination and neonatal feeding strategy was detected. The group of exclusively breastfeeding mothers, in comparison to formula- and mixed-feeding women, was characterized by having lower pre-pregnancy BMI and previous maternal experience. Conclusions: Rates of vaccination against seasonal influenza and dual (influenza and COVID-19) vaccination remain low among Polish mothers. The promotion of antenatal vaccination and reliable information about short- and long-term advantages related to breastfeeding are crucial to perinatal health care for the mother-infant dyad. Young, primiparous women who are overweight or obese should be targets of preventive programs focused on the health of the mother-infant dyad.

Knowledge, attitudes, and perceptions of influenza vaccine among pregnant women in Minhang District, Shanghai

This study aimed to assess the attitudes and willingness of pregnant women to receive the influenza vaccine and the factors influencing their decisions. A sample survey was conducted among pregnant women receiving prenatal care at various medical institutions in Minhang District, Shanghai, from March to June 2023. The survey included inquiries about demographic information, knowledge, and perception of influenza disease and influenza vaccine. Logistic regression models and chi-square tests were used to analyze the data. 6.9% (78/1125) of participants considered receiving the influenza vaccine during pregnancy. Participants with graduate education or above (OR = 4.632, 95%CI: 1.046-20.517), non-office workers (OR = 2.784, 95%CI: 1.560-4.970), and participants whose spouses were not office workers (OR = 0.518, 95% CI: 0.294-0.913) were significantly associated with high intent to vaccinate. Participants with superior knowledge (>30 points) exhibited greater willingness (p < .001). Participants who viewed post-influenza symptoms as mild had a significantly lower willingness to vaccinate during pregnancy (2.3%), compared to those who disagreed (p = .015). Conversely, those recognizing a heightened risk of hospitalization due to respiratory diseases in pregnant women post-influenza were significantly more inclined to vaccinate during pregnancy (8.8%) (p = .007). Participants recognizing benefits uniformly expressed willingness to receive the influenza vaccine during pregnancy (p < .001), while those perceiving barriers uniformly rejected vaccination (p < .001). Higher education, non-office worker status, and having an office worker spouse correlate with greater willingness to receive the influenza vaccine during pregnancy. Enhanced knowledge and accurate perceptions of influenza and its vaccine influenced willingness. Accumulating knowledge about influenza and its vaccine fosters accurate perceptions. Notably, overall willingness to vaccinate during pregnancy remains low, likely due to safety concerns, and lack of accurate perceptions. Targeted health education, improved communication between healthcare providers and pregnant women, and campaigns highlighting vaccine benefits for mothers and children are essential.

Good teaching practices for organizing and conducting clinical classes in obstetrics and gynaecology for medical undergraduate students at the English Division

The Medical University of Warsaw is one of Poland's largest medical universities, currently enrolling nearly 10,000 students, including 608 international undergraduates.This manuscript aims to share our experience with a literature review on organizing and coordinating clinical classes for English Division undergraduate medical students at a single centre in a country where English is not an official language. We would like to highlight certain aspects that have proven highly beneficial in our educational efforts and offer universal advice applicable to clinical classes in any specialty.In this publication, we summarize and emphasize the critical aspects of creating conducive conditions for acquiring knowledge and practical skills by English Division students. We provide readers with good practices for tutor selection, organizational aspects, preparation of educational materials, presenting theoretical knowledge, teaching practical skills, medical simulations, doctor-patient communication, learning progress evaluation, comparison of diverse healthcare environments, students' feedback, and creating opportunities for further development after course completion.

Maternal Vaccination in Pregnancy: An Assessment of Influenza, Pertussis, and COVID-19 Vaccination Rates in Cracow, Poland

BACKGROUND Maternal vaccination during pregnancy reduces the risk of severe course and complications from infections both for the mother and her child. As information regarding immunization status of pregnant women with recommended vaccines in Poland is scarce, this questionnaire-based study aimed to identify influenza, pertussis (whooping cough), and COVID-19 vaccination in 205 pregnant women in Cracow, Poland, between February and April 2023. Another objective was to assess whether any of the maternal factors might influence women's decision to inoculate during pregnancy. MATERIAL AND METHODS An anonymous and self-reported questionnaire developed specifically for this study was disseminated among postpartum women, who gave birth and were hospitalized at the Department of Obstetrics and Perinatology of the University Hospital in Cracow, Poland, between February and April 2023. Study participants were asked about their basic sociodemographic and obstetric data, as well as their immunization status regarding influenza, pertussis, and COVID-19 during their most recent pregnancy. RESULTS Only 12.2% and 23.4% of study participants received influenza and pertussis vaccinations, respectively, during pregnancy, while 61.5% of pregnant women reported vaccination with at least 2 doses of the mRNA COVID-19 vaccine. Features including type of occupation, place of residence, gravidity, and parity were statistically significant (P.

The Obstetrician's Role in Pregnant Women's Decision-Making Process Regarding Influenza and COVID-19 Vaccination

Pregnant women are considered to be a population vulnerable to influenza and COVID-19 infections, and the latest guidelines consistently recommend that they receive influenza and COVID-19 vaccinations. A cross-sectional questionnaire-based study was conducted among pregnant women in Poland to determine which factors have the greatest impact on their decision to vaccinate against influenza and COVID-19. A total of 515 pregnant women participated in the study. Among them, 38.4% (n = 198) demonstrated a positive attitude toward influenza vaccination, and 64.3% (n = 331) demonstrated a positive attitude toward COVID-19 vaccination. Logistic regression analysis revealed that the strongest influence on positive attitudes toward COVID-19 vaccination is having it recommended by an obstetrician-gynecologist (OR = 2.439, p = 0.025). The obstetrician-gynecologist's recommendation to vaccinate against influenza also significantly influences the decision to vaccinate (OR = 5.323). The study results also show a strong correlation between the obstetrician-gynecologist as a source of information on influenza and vaccination and participants' positive attitudes toward vaccination (OR = 4.163). Obstetricians have a significant influence on pregnant women's decisions regarding vaccinations. Further recommendations to vaccinate and awareness-raising among obstetricians may be needed to increase the vaccination rate of pregnant women in Poland.

Impact of the COVID-19 Pandemic on Influenza Vaccination and Associated Factors among Pregnant Women: A Cross-Sectional Study in Korea

Pregnant women are vulnerable to developing influenza complications. Influenza vaccination during pregnancy is crucial to avoid infection. The COVID-19 pandemic might exacerbate fear and anxiety in pregnant women. The purpose of this study was to evaluate the effect of the COVID-19 pandemic on influenza vaccination and determine the factors associated with influenza vaccine acceptance among pregnant women in Korea. We conducted a cross-sectional study using an online survey in Korea. A survey questionnaire was distributed among pregnant or postpartum women within 1 year after delivery. Multivariate logistic regression analysis was performed to identify the factors associated with influenza vaccination among pregnant women. A total of 351 women were included in this study. Of them, 51.0% and 20.2% were vaccinated against influenza and COVID-19 during pregnancy, respectively. The majority of participants who had a history of influenza vaccination reported that the COVID-19 pandemic did not affect (52.3%, n = 171) or increased the importance (38.5%, n = 126) of their acceptance of the influenza vaccine. Factors associated with influenza vaccine acceptance were knowledge of influenza vaccine (OR 1.21; 95% CI 1.09, 1.35), trust in healthcare providers (OR 2.57; 95% CI 1.43, 4.65), and COVID-19 vaccination during pregnancy (OR 6.11, 95% CI 2.86, 13.01). Participants were more likely to accept the influenza vaccine when they received a COVID-19 vaccine during pregnancy, but the rate of influenza vaccination was not affected by the COVID-19 pandemic. This study showed that the COVID-19 pandemic did not influence influenza vaccine uptake in the majority of pregnant women in Korea. The results emphasize the necessity of appropriate education for pregnant women to enhance awareness of vaccination.

Influence of the COVID-19 pandemic and social media on the behaviour of pregnant and lactating women towards vaccination: a scoping review

BACKGROUND

Pregnant women, foetuses and infants are at risk of infectious disease-related complications. Maternal vaccination is a strategy developed to better protect pregnant women and their offspring against infectious disease-related morbidity and mortality. Vaccines against influenza, pertussis and recently also COVID-19 are widely recommended for pregnant women. Yet, there is still a significant amount of hesitation towards maternal vaccination policies. Furthermore, contradictory messages circulating social media impact vaccine confidence.

OBJECTIVES

This scoping review aims to reveal how COVID-19 and COVID-19 vaccination impacted vaccine confidence in pregnant and lactating women. Additionally, this review studied the role social media plays in creating opinions towards vaccination in these target groups.

ELIGIBILITY CRITERIA

Articles published between 23 November 2018 and 18 July 2022 that are linked to the objectives of this review were included. Reviews, articles not focusing on the target group, abstracts, articles describing outcomes of COVID-19 infection/COVID-19 vaccination were excluded.

SOURCES OF EVIDENCE

The PubMed database was searched to select articles. Search terms used were linked to pregnancy, lactation, vaccination, vaccine hesitancy, COVID-19 and social media.

CHARTING METHODS

Included articles were abstracted and synthesised by one reviewer. Verification was done by a second reviewer. Disagreements were addressed through discussion between reviewers and other researchers.

RESULTS

Pregnant and lactating women are generally less likely to accept a COVID-19 vaccine compared with non-pregnant and non-nursing women. The main reason to refuse maternal vaccination is safety concerns. A positive link was detected between COVID-19 vaccine willingness and acceptance of other vaccines during pregnancy. The internet and social media are identified as important information sources for maternal vaccination.

DISCUSSION AND CONCLUSION

Vaccine hesitancy in pregnant and lactating women remains an important issue, expressing the need for effective interventions to increase vaccine confidence and coverage. The role social media plays in vaccine uptake remains unclear.