{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T08:46:30Z","timestamp":1784796390582,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T00:00:00Z","timestamp":1546905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005758","name":"Universit\u00e0 Politecnica delle Marche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005758","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pregnant women are at increased risk of influenza complications. Influenza vaccine provides them a substantial protection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to investigate determinants associated with non\u2010adherence to influenza vaccine recommendations in pregnant women in Italy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional study has been carried out among pregnant women attending their follow\u2010up visit in some mother and child services in a Region of Italy from October 2016 to January 2017. The study protocol was approved by the local research Ethics. A self\u2010administered close\u2010ended questionnaire has been administered to the pregnant women. Differences in background, socio\u2010demographic characteristics, knowledge and attitudes towards flu vaccine were tested in vaccinated and unvaccinated women. Multivariate analysis was performed to control for confounding factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three hundred and sixty\u2010six women answered the survey (97% response rate) and 96.1% (348) declared of being unvaccinated against influenza during the 2016\u20102017 influenza season. Frequent reasons for refusing vaccination were drugs objection and concerns about vaccines\u2019 effects. According to the refusal attitude, influenza knowledge was low in the group. Moreover, analysis showed that low adherence to vaccination is associated to lacking promotion of vaccination to pregnant women carried out by healthcare workers (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Healthcare workers have a key role in assisting women during the gestational period, so their active involvement in vaccination promotion is essential. It is necessary to improve health care workers\u2019 knowledge about vaccine relevance in protecting pregnancy and their communication skills to properly inform pregnant women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/irv.12600","type":"journal-article","created":{"date-parts":[[2018,8,12]],"date-time":"2018-08-12T11:44:30Z","timestamp":1534074270000},"page":"201-207","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Factors influencing refusing of flu vaccination among pregnant women in Italy: Healthcare workers\u2019 role"],"prefix":"10.1111","volume":"13","author":[{"given":"Emilia","family":"Prospero","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences Section of Hygiene Universit\u00e0 Politecnica delle Marche  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Galmozzi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Section of Hygiene Universit\u00e0 Politecnica delle Marche  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Paris","sequence":"additional","affiliation":[{"name":"Woman's Health Sciences Department Gynecologic Section AOU Ospedali Riuniti Ancona  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gessica","family":"Felici","sequence":"additional","affiliation":[{"name":"Woman's Health Sciences Department Gynecologic Section AOU Ospedali Riuniti Ancona  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Barbadoro","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Section of Hygiene Universit\u00e0 Politecnica delle Marche  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"D'Alleva","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Section of Hygiene Universit\u00e0 Politecnica delle Marche  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2167-3197","authenticated-orcid":false,"given":"Gemma","family":"Zocco","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Section of Hygiene Universit\u00e0 Politecnica delle Marche  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ciavattini","sequence":"additional","affiliation":[{"name":"Woman's Health Sciences Department Gynecologic Section AOU Ospedali Riuniti Ancona  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S47235"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14760584.2016.1175304"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.06.068"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2015.11.020"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1401480"},{"key":"e_1_2_8_7_1","first-page":"461","article-title":"Vaccines against influenza WHO position paper \u2013 November 2012","volume":"87","author":"World Health Organization (WHO)","year":"2012","journal-title":"Wkly Epidemiol Rec"},{"key":"e_1_2_8_8_1","unstructured":"Ministero della salute.Prevenzione e controllo dell'influenza: raccomandazioni per la stagione 2016\u20102017."},{"key":"e_1_2_8_9_1","first-page":"1","article-title":"Strategies in recommending influenza vaccination in Europe and US","volume":"18","author":"Rizzo C","year":"2017","journal-title":"Hum Vaccin Immunother"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2015.03.041"},{"key":"e_1_2_8_11_1","volume-title":"Overview of Vaccination Recommendations an Coverage Rates in the EU Member States for 2012\u20102013 Influenza Season","author":"European Center for Disease Prevention and Control. 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