Vaccine hesitancy: old defeat or new challenge for public health? A survey on pregnant women in Rome

Background In recent years childhood vaccination coverages in Italy decreased well below the recommended thresholds. This fall seems to be due largely to the increase of parents who decide to delay or even to decline vaccinations. Therefore, we aimed to identify level and determinants of knowledge and attitudes about vaccinations and vaccine hesitancy of a population of pregnant women. Methods A questionnaire was administered (June 2016 - March 2017) to 360 randomly selected pregnant women during their antenatal classes in 35 community Mother and Baby Centers, representative of the entire metropolitan area of Rome (Italy). Results Mean age of respondents was 32.9 (±5.1) and 90% were giving birth for the first time. A good level of knowledge (≥75% correct answers), showed by 24.0% of respondents, was associated with a positive attitude of lower acceptance of the most common anti-vaccine theses: scare of serious side effects (OR = 0.12; 95% CI = 0.06-0.26), biased information provided by physicians (OR = 0.35; 95% CI = 0.18–0.71), economic interest of pharmaceutical companies (OR = 0.13; 95% CI = 0.04–0.46). Different levels of hesitancy were reported for hexavalent (22.1%), MMR (34.9%) and MEN-C vaccines (41.1%). A significant lower hesitancy against the three vaccines was found in women with a good level of knowledge and in those who received information by healthcare workers (globally 35.8% of respondents) only for MMR (OR = 0.52; 95% CI = 0.30–0.93) and MEN-C (OR = 0.57; 95% CI = 0.33–0.99). Conclusions Lack of knowledge is a strong predictor of vaccine hesitancy. The final aim of this study is to provide specific training programs to healthcare professionals involved in pregnancy management. This may help them to transfer the correct vaccination information for the empowerment and the growth of vaccine culture. An increase of the vaccine coverages in the metropolitan area of Rome is expected with the implementation of this program.