Reducing vaccine hesitancy in pregnancy by the health literacy model inclusive of modern communication tools

Albeit the vaccination is one of the most successful and cost-effective public health interventions, reluctance or refusal to vaccinate represents one of the ten threats to global health by the World Health Organization. Additional efforts to promote vaccination are required for at higher risk categories, such as pregnant women. Our approach supports the role of a clear and transparent communication by using efficient interventions and educational strategies to increase both willingness and confidence for preventable diseases in neonates and infants by vaccinations in pregnancy.

Increasing Vaccine Uptake during Pregnancy by Using Prenatal Education Classes: An Effective Tool for Health Communication and Promotion

Childbirth education classes represent an antenatal tool for supporting pregnant women and couples in increasing knowledge on pregnancy, delivery, breastfeeding, and newborn care. The aim of this study was to investigate the impact of an additional lesson during the prenatal course regarding the advantage of vaccination to mitigation of maternal anxiety. An observational study was designed that included participants in childbirth education classes and compared courses enhanced by the extra lesson on vaccination during pregnancy versus those who did not receive it. Assessment of the impact of prenatal educational on vaccination was measured by using validated questionnaires (State-Trait Anxiety Inventory, STAI; Perceived Stress Scale, PSS; World Health Organization- Five Well-Being Index, WHO-5). A total of 145 pregnant women participated to the investigation by answering to the online survey. Of them, 33 patients (22.8%) belonged to the course without a lesson on vaccine, while 112 (77.2%) participated to online prenatal education that included an additional meeting on the usefulness of getting vaccinated during pregnancy. No statistical differences were found between study groups in terms of demographics and perinatal outcomes. Participants in the enriched course reported lower basal anxiety levels than those without the vaccine lesson (STAI-State, normal score < 40, 30 vs. 19%, p-value 0.041; STAI-State, mild score 40-50, 78 vs. 67%, p-value 0.037). With reference to the prior two weeks, maternal wellbeing level was improved by the added class (score > 13 as measurement of wellbeing: 62% vs. 80%, p-value < 0.05). Moderate perceived stress assessed by PSS was found in those pregnant women without prenatal education on vaccination (64 vs. 50%, p-value 0.042). The introduction of a lesson regarding vaccination during pregnancy in the program of prenatal education courses improved maternal anxiety levels and wellbeing, in addition to reducing perceived stress.

Anthropogenically derived mercury in sediments of Pialassa Baiona, Ravenna, Italy

Pialassa Baiona, a coastal wetland near the city of Ravenna, has been impacted for two decades (1958-1978) by industrial discharges containing mercury and floating agglomerates of residues of polymerization processes. Although the industrial use of mercury completely ceased in the early 90's, surface sediments are still highly contaminated, mercury concentrations decreasing from the southern sub-basin, close to the discharge point, to the farthest northern border. Concentrations of total mercury, synthetic polymers (determined by pyrolysis-GC/MS), total organic carbon, C/N ratio, total sulfur and 210Pb dating, were determined in sediment cores collected in the southern and northern sub-basins. Mercury and polymers exhibited parallel profiles with a peak corresponding to the historic emission record in the southern core, while in northern cores peaks of maximum concentration display a delay reflecting the time required for the pollutants to migrate. A recently developed mercury sequential extraction procedure was applied to the most polluted layers to study inorganic mercury speciation. Results indicate differences between the southern and northern areas, suggesting a more efficient binding of mercury to sediments in the southern sub-basin.