Factors influencing influenza and pertussis vaccination coverage among pregnant women in Poland - a cross- sectional study

Background: Vaccination of pregnant women is an essential part of obstetric care, offering protection for both the mother and the neonate. Pregnant women and infants are at risk for a severe course of influenza and pertussis. This study aimed to investigate factors influencing influenza and pertussis vaccination coverage among pregnant women in Poland during the early COVID-19 pandemic. Methods: An anonymous, self-administered, cross-sectional online survey was conducted over 4 months in 2020/ 2021 among adult pregnant patients at any gestational stage. The analysis considered age, education, parity, and comorbidities. Results: 376 patients met the inclusion criteria. Most had higher education, a non-medical background, and were during uncomplicated first pregnancy. The majority believed that influenza (78%) and pertussis (58%) pose risk to pregnant and postpartum women, while 91% recognized pertussis as dangerous to newborns. However, nearly 20% were uncertain whether influenza poses neonatal risks, and fewer than half felt sufficiently informed about vaccination during pregnancy. Over 31% declared receiving the influenza vaccination in pre-pregnancy 2019/2020 season, but only 17% were vaccinated annually. 44% had never been vaccinated, and an additional 21% were unwilling to be vaccinated in the future. The most common reasons for vaccine refusal were doubts about effectiveness, fear of side effects for the mother and/or baby, and the perception of it as a rare disease. Older gravidas tended to view influenza vaccination as safe, effective, and necessary, though differences were not statistically significant. Obstetricians were indicated as sources of vaccine information by 27% of respondents for influenza and 29% for pertussis, while family doctors or other specialists were pointed by 46% and 28%, respectively. Nearly 68% indicated that receiving a free vaccine during routine gynecological or specialist visit would be the most convenient option. Conclusions: Vaccination coverage among pregnant women in Poland against influenza and pertussis remains suboptimal. Key factors that can enhance the immunization rate among pregnant women have been identified. Educating patients and the public about vaccine benefits, effectiveness and safety is essential. Additionally, medical personnel should be educated about effective methods to inform patients about vaccinations during pregnancy, including their safety and benefits.