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      Conocimiento, actitudes y prácticas de mujeres gestantes respecto a la vacunación Translated title: Knowledge, attitudes and practices of pregnant women regarding vaccination

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          Abstract

          Resumen Introducción: La vacunación durante el embarazo ha demostrado ser una medida segura y efectiva que protege a la mujer gestante y al feto contra enfermedades inmunoprevenibles. Objetivo: Determinar los conocimientos, actitudes y prácticas de mujeres gestantes respecto a la vacunación en el marco de la pandemia por el virus SARS-CoV-2. Materiales y Métodos: Estudio observacional de corte transversal realizado en Instituciones Prestadoras de Servicios de Salud Públicas de los 19 municipios de Casanare, Colombia, entre enero y marzo de 2022. Los datos se recolectaron mediante un instrumento de medición documentado que incluyó 22 ítems agrupados en cuatro secciones: datos sociodemográficos, conocimiento, actitudes y prácticas sobre vacunación. Resultados: La media de puntuación de conocimientos fue 5,9 (DE 1,9) de un máximo de 10. El 93,7% cree que la vacunación es realmente necesaria durante el embarazo. Los factores asociados al nivel adecuado de conocimiento incluyeron el grupo de edad entre 26-30 años (OR: 2,27; IC 95%: 1,21-4,25; p = 0,011), estar en el tercer trimestre de embarazo (OR: 2,37; IC 95%: 1,12-5,01; p = 0,024) y contar con un nivel educativo básico, medio o superior (OR: 10,45; IC 95%: 2,37-46,03; p = 0,002). Conclusión: Es esencial fortalecer las estrategias de información, educación y comunicación, para promover la vacunación segura durante el embarazo.

          Translated abstract

          Abstract Background: Vaccination during pregnancy has proven to be a safe and effective measure that protects pregnant woman and the fetus against immuno-preventable diseases. Aim: To determine the knowledge, attitudes and practices of pregnant women regarding vaccination in the context of the SARS-CoV-2 pandemic. Methods: A cross-sectional observational study was conducted at public health care institutions in the 19 municipalities of Casanare, Colombia, from January to March 2022. Data were collected using a documented measurement instrument that included 22 items grouped into four sections: sociodemographic data, knowledge, attitudes and practices about vaccination. Results: The mean knowledge score was 5.9 (SD: 1.9) of a maximun of 10; 93.7% believed that vaccination was really necessary during pregnancy. Factors associated with adequate level of knowledge included age group 26-30 years (OR: 2.27; 95% CI: 1.21-4.25; p = 0.011), being in the third trimester of pregnancy (OR: 2.37; 95% CI: 1.12-5.01; p = 0.024) and having basic, intermediate or higher education (OR: 10.45; 95% CI: 2.37-46.03; p = 0.002). Conclusions: It is essential to strengthen information, education and communication strategies to promote safe vaccination during pregnancy.

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          Understanding factors influencing vaccination acceptance during pregnancy globally: A literature review.

          Maternal vaccination has been evaluated and found to be extremely effective at preventing illness in pregnant women and new-borns; however, uptake of such programmes has been low in some areas. To analyse factors contributing to uptake of vaccines globally, a systematic review on vaccine hesitancy was carried out by The Vaccine Confidence Project in 2012. In order to further analyse factors contributing to uptake of maternal immunisation, a further search within the broader systematic review was conducted using the terms 'Pregnan*' or 'Matern*'. Forty-two articles were identified. Pregnancy-related articles were further screened to identify those focused on concerns, trust and access issues regarding maternal vaccination reported by pregnant women and healthcare workers. Thirty-five relevant articles were included which were then searched using the snowballing technique to identify additional relevant references cited in these articles. A search alert was also conducted from February to April 2015 in PubMed to ensure that no new relevant articles were missed. A total of 155 relevant articles were included. Most of the literature which was identified on hesitancy surrounding vaccination during pregnancy reports on determinants of influenza vaccine uptake in North America. Research conducted in low-income countries focused primarily on tetanus vaccine acceptance. The main barriers cited were related to vaccine safety, belief that vaccine not needed or effective, not recommended by healthcare worker, low knowledge about vaacines, access issues, cost, conflicting advice. From the point of view of healthcare workers, barriers included inadequate training, inadequate reimbursement and increased workload. Twenty-seven out of 46 (59%) articles mentioning ethnicity reported lower rates of coverage among ethnic minorities. Barriers to vaccination in pregnancy are complex and vary depending on context and population. There are wide gaps in knowledge regarding the attitudes of healthcare workers and how ethnicity and gender dynamics influence a pregnant woman's decision to vaccinate.
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            Maternal Immunological Adaptation During Normal Pregnancy

            The risk and severity of specific infections are increased during pregnancy due to a combination of physiological and immunological changes. Characterizing the maternal immune system during pregnancy is important to understand how the maternal immune system maintains tolerance towards the allogeneic fetus. This may also inform strategies to prevent maternal fatalities due to infections and optimize maternal vaccination to best protect the mother-fetus dyad and the infant after birth. In this review, we describe what is known about the immunological changes that occur during a normal pregnancy.
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              COVID‐19 vaccine acceptance in pregnant women

              Objective To determine vaccine acceptance and hesitancy attitudes toward coronavirus disease 2019 (COVID‐19) vaccines in pregnant women. Methods Three hundred pregnant women were surveyed face to face with 40 questions. Sociodemographic characteristics, vaccination history, perception of risk for the COVID‐19 pandemic, the impact of the COVID‐19 pandemic, and acceptance of and attitude toward future COVID‐19 vaccination were prospectively evaluated. Results Among all participants, 111 (37%) stated their intent to receive the vaccine if it were recommended for pregnant women. Most common refusal reasons were lack of data about COVID‐19 vaccine safety in pregnant populations and possibility of harm to the fetus. There was a weak positive correlation between COVID‐19 vaccine acceptancy and number of school‐age children. Pregnant women in the first trimester expressed higher acceptance of COVID‐19 vaccination than those in the second and third trimesters. Conclusion The present study reported low acceptance of COVID‐19 vaccination in a sample of pregnant women. Concern about vaccine safety was the major reason for hesitancy. Identifying attitudes among priority groups will be useful for creating vaccination strategies that increase uptake during the current pandemic. Identifying attitudes among priority groups like pregnant women will be useful to create vaccination strategies in the prevention and control of COVID‐19.
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                Author and article information

                Journal
                rci
                Revista chilena de infectología
                Rev. chil. infectol.
                Sociedad Chilena de Infectología (Santiago, , Chile )
                0716-1018
                June 2023
                : 40
                : 3
                : 220-227
                Affiliations
                [1] Casanare orgnameSecretaria de Salud Departamental Colombia
                Article
                S0716-10182023000300220 S0716-1018(23)04000300220
                10.4067/s0716-10182023000300220
                74acc0e7-ce8e-420e-a129-326d526e2500

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 07 September 2022
                : 20 March 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 8
                Product

                SciELO Chile

                Categories
                VACUNOLOGÍA

                influenza vaccine,COVID-19 vaccine,Tdap vaccine,vacuna COVID-19,vacuna influenza,pregnant women,vacuna Tdap,vacunación,mujeres embarazadas,vaccination

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