{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T02:06:31Z","timestamp":1769825191266,"version":"3.49.0"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":33,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Directorate-General of Health"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"DOI":"10.1186\/s12889-025-25591-y","type":"journal-article","created":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:42:24Z","timestamp":1766882544000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influenza and COVID-19 vaccination intention in Portuguese adults from at-risk groups: a mixed-method study"],"prefix":"10.1186","volume":"26","author":[{"given":"Cristina A.","family":"Godinho","sequence":"first","affiliation":[]},{"given":"Rita","family":"Francisco","sequence":"additional","affiliation":[]},{"given":"Rui","family":"Gaspar","sequence":"additional","affiliation":[]},{"given":"Joana","family":"Henriques","sequence":"additional","affiliation":[]},{"given":"Andreia","family":"Costa","sequence":"additional","affiliation":[]},{"given":"Jo\u00e3o","family":"Ant\u00f3nio","sequence":"additional","affiliation":[]},{"given":"Diana","family":"Costa","sequence":"additional","affiliation":[]},{"given":"Teresa","family":"Fernandes","sequence":"additional","affiliation":[]},{"given":"Miguel","family":"Arriaga","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"issue":"34","key":"25591_CR1","doi-asserted-by":"publisher","first-page":"4161","DOI":"10.1016\/j.vaccine.2015.04.036","volume":"33","author":"NE MacDonald","year":"2015","unstructured":"MacDonald NE. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33(34):4161\u20134.","journal-title":"Vaccine"},{"issue":"1","key":"25591_CR2","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1146\/annurev-publhealth-090419-102240","volume":"42","author":"\u00c8 Dub\u00e9","year":"2021","unstructured":"Dub\u00e9 \u00c8, Ward JK, Verger P, MacDonald NE. Vaccine hesitancy, acceptance, and anti-vaccination: trends and future prospects for public health. Annu Rev Public Health. 2021;42(1):175\u201391.","journal-title":"Annu Rev Public Health"},{"issue":"10","key":"25591_CR3","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.3390\/vaccines9101161","volume":"9","author":"N Fernandes","year":"2021","unstructured":"Fernandes N, Costa D, Costa D, Keating J, Arantes J. Predicting COVID-19 vaccination intention: the determinants of vaccine hesitancy. Vaccines. 2021;9(10):1161.","journal-title":"Vaccines"},{"issue":"6","key":"25591_CR4","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.pulmoe.2022.03.005","volume":"28","author":"F Froes","year":"2022","unstructured":"Froes F, Morais A, Hespanhol V, Nogueira R, Carlos JS, Jacinto N, et al. The Vacin\u00f3metro\u00ae initiative: an eleven-year monitorization of influenza vaccination coverage rates among risk groups in Portugal. Pulmonology. 2022;28(6):427\u201330.","journal-title":"Pulmonology"},{"key":"25591_CR5","doi-asserted-by":"crossref","unstructured":"Joshi A, Kaur M, Kaur R, Grover A, Nash D, El-Mohandes A. Predictors of COVID-19 vaccine acceptance, intention, and hesitancy: a scoping review. Front Public Heal. 2021;9:698111.","DOI":"10.3389\/fpubh.2021.698111"},{"issue":"8","key":"25591_CR6","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1177\/13591053231161891","volume":"28","author":"GM Breakwell","year":"2023","unstructured":"Breakwell GM, Jaspal R, Wright DB. Identity resilience, science mistrust, COVID-19 risk and fear predictors of vaccine positivity and vaccination likelihood: A survey of UK and Portuguese samples. J Health Psychol. 2023;28(8):747\u201359.","journal-title":"J Health Psychol"},{"issue":"1","key":"25591_CR7","doi-asserted-by":"publisher","first-page":"34","DOI":"10.2991\/jegh.k.200906.001","volume":"11","author":"K Choucair","year":"2020","unstructured":"Choucair K, El Sawda J, Assaad S, El Chakhtoura NG, Hassouna H, Sidani N, et al. Knowledge, perception, attitudes and behavior on influenza immunization and the determinants of vaccination. J Epidemiol Glob Health. 2020;11(1):34.","journal-title":"J Epidemiol Glob Health"},{"issue":"8","key":"25591_CR8","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.3390\/vaccines10081349","volume":"10","author":"C Pires","year":"2022","unstructured":"Pires C. Global predictors of COVID-19 vaccine hesitancy: A systematic review. Vaccines. 2022;10(8):1349.","journal-title":"Vaccines"},{"issue":"36","key":"25591_CR9","doi-asserted-by":"publisher","first-page":"5304","DOI":"10.1016\/j.vaccine.2023.07.017","volume":"41","author":"I Sabat","year":"2023","unstructured":"Sabat I, Neumann-B\u00f6hme S, Barros PP, Torbica A, van Exel J, Brouwer W, et al. Vaccine hesitancy comes in waves: longitudinal evidence on willingness to vaccinate against COVID-19 from seven European countries. Vaccine. 2023;41(36):5304\u201312.","journal-title":"Vaccine"},{"key":"25591_CR10","doi-asserted-by":"crossref","unstructured":"Eagan RL, Larson HJ, de Figueiredo A. Recent trends in vaccine coverage and confidence: a cause for concern. Hum Vaccin Immunother. 2023;19(2):2237374.","DOI":"10.1080\/21645515.2023.2237374"},{"issue":"10255","key":"25591_CR11","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1016\/S0140-6736(20)31558-0","volume":"396","author":"A de Figueiredo","year":"2020","unstructured":"de Figueiredo A, Simas C, Karafillakis E, Paterson P, Larson HJ. Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective Temporal modelling study. Lancet. 2020;396(10255):898\u2013908.","journal-title":"Lancet"},{"key":"25591_CR12","unstructured":"de Figueiredo A, Eagan RL, Hendrickx G, Karafillakis E, van Damme P, Larson HJ. State of vaccine confidence in the European Union 2022. 2022."},{"key":"25591_CR13","unstructured":"Larson H, de Figueiredo A, Karafillakis E, Rawal M. State of vaccine confidence in the EU 2018. Luxembourg; 2018. Available from: https:\/\/health.ec.europa.eu\/system\/files\/2018-11\/2018_vaccine_confidence_en_0.pdf."},{"issue":"4","key":"25591_CR14","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1016\/j.vaccine.2017.12.019","volume":"36","author":"P Jorgensen","year":"2018","unstructured":"Jorgensen P, Mereckiene J, Cotter S, Johansen K, Tsolova S, Brown C. How close are countries of the WHO European region to achieving the goal of vaccinating 75% of key risk groups against influenza? Results from National surveys on seasonal influenza vaccination programmes, 2008\/2009 to 2014\/2015. Vaccine. 2018;36(4):442\u201352.","journal-title":"Vaccine"},{"key":"25591_CR15","unstructured":"Mathieu E, Ritchie H, Rod\u00e9s-Guirao L, Appel C, Giattino C, Hasell J et al. Portugal: What share of the population has completed the initial vaccination protocol? [Internet]. Our World In Data. 2020 [cited 2023 Jun 15]. Available from: https:\/\/ourworldindata.org\/coronavirus\/country\/portugal"},{"key":"25591_CR16","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade. Campanha de Vacina\u00e7\u00e3o Sazonal contra a COVID-19: OutonoInverno 2023-2024. 005\/2023 Portugal; 2023. Available from: https:\/\/www.dgs.pt\/normas-orientacoes-e-informacoes\/normas-e-circulares-normativas\/norma-0052023-de-13092023-atualizada-a-12012024-pdf.aspx."},{"key":"25591_CR17","unstructured":"Sociedade Portuguesa de Pneumologia. Vacin\u00f3metro\u00ae \u00c9poca 2022\/2023. 4a vaga [Internet]. 2023 [cited 2023 Oct 31]. Available from: https:\/\/www.sppneumologia.pt\/noticias\/vacinometro-dados-finais-da-epoca-gripal-de-2022-2023-revelam-que-832-dos-portugueses-com-65-ou-mais-anos-de-idade-terao-sido-vacinados"},{"key":"25591_CR18","unstructured":"Sociedade Portuguesa de Pneumologia. Vacin\u00f3metro\u00ae \u00c9poca 2024\/2025. 4a vaga [Internet]. 2025 [cited 2025 Jul 21]. Available from: https:\/\/www.sppneumologia.pt\/uploads\/subcanais_conteudos_ficheiros\/relat\u00e33rio-vacin\u00e33metro-4\u00e2a-vaga-2024-2025.pdf"},{"key":"25591_CR19","unstructured":"Associa\u00e7\u00e3o Portuguesa de Medicina Geral e Familiar. Mais de 370 mil portugueses com idade igual ou superior a 60 anos j\u00e1 ter\u00e3o sido vacinados contra a gripe [Internet]. 2023 [cited 2023 Oct 31]. Available from: https:\/\/apmgf.pt\/2023\/10\/20\/mais-de-370-mil-portugueses-com-idade-igual-ou-superior-a-60-anos-ja-terao-sido-vacinados-contra-a-gripe\/"},{"issue":"9","key":"25591_CR20","doi-asserted-by":"publisher","first-page":"3185","DOI":"10.3390\/ijerph17093185","volume":"17","author":"A Arghittu","year":"2020","unstructured":"Arghittu A, Dettori M, Azara A, Gentili D, Serra A, Contu B, et al. Flu vaccination attitudes, behaviours, and knowledge among health workers. Int J Environ Res Public Health. 2020;17(9):3185.","journal-title":"Int J Environ Res Public Health"},{"issue":"8","key":"25591_CR21","doi-asserted-by":"publisher","first-page":"2378","DOI":"10.4161\/hv.29142","volume":"10","author":"A Dom\u00ednguez","year":"2014","unstructured":"Dom\u00ednguez A, Godoy P, Castilla J, Mar\u00eda Mayoral J, Soldevila N, Torner N, et al. Knowledge of and attitudes to influenza in unvaccinated primary care physicians and nurses. Hum Vaccin Immunother. 2014;10(8):2378\u201386.","journal-title":"Hum Vaccin Immunother"},{"issue":"41","key":"25591_CR22","doi-asserted-by":"publisher","first-page":"5013","DOI":"10.1016\/j.vaccine.2016.08.029","volume":"34","author":"E Karafillakis","year":"2016","unstructured":"Karafillakis E, Dinca I, Apfel F, Cecconi S, W\u0171rz A, Takacs J, et al. Vaccine hesitancy among healthcare workers in europe: A qualitative study. Vaccine. 2016;34(41):5013\u201320.","journal-title":"Vaccine"},{"key":"25591_CR23","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.bpobgyn.2021.03.007","volume":"76","author":"M Sebghati","year":"2021","unstructured":"Sebghati M, Khalil A. Uptake of vaccination in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2021;76:53\u201365.","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"issue":"49","key":"25591_CR24","doi-asserted-by":"publisher","first-page":"7445","DOI":"10.1016\/j.vaccine.2018.10.046","volume":"36","author":"CS Lutz","year":"2018","unstructured":"Lutz CS, Carr W, Cohn A, Rodriguez L. Understanding barriers and predictors of maternal immunization: identifying gaps through an exploratory literature review. Vaccine. 2018;36(49):7445\u201355.","journal-title":"Vaccine"},{"key":"25591_CR25","unstructured":"European Centre for Disease Prevention and Control. Survey report on national seasonal influenza vaccination recommendations and coverage rates in EU\/EEA countries. Stockholm; 2024. Available from: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/survey-report-national-seasonal-influenza-vaccination-recommendations."},{"key":"25591_CR26","volume-title":"Relat\u00f3rio semanal: vacina\u00e7\u00e3o sazonal","author":"Dire\u00e7\u00e3o-Geral da Sa\u00fade","year":"2024","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade. Relat\u00f3rio semanal: vacina\u00e7\u00e3o sazonal. Jan: Lisboa; 2024."},{"issue":"3","key":"25591_CR27","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.sapharm.2022.10.011","volume":"19","author":"J Wang","year":"2023","unstructured":"Wang J, Li T, Ge J, Zhou M, Walker AN, Chen J, et al. Applying two behavioral theories to predict the willingness to receive COVID-19 vaccine booster in the elderly: A cross-sectional study. Res Soc Adm Pharm. 2023;19(3):495\u2013501.","journal-title":"Res Soc Adm Pharm"},{"issue":"6","key":"25591_CR28","doi-asserted-by":"publisher","first-page":"e0234702","DOI":"10.1371\/journal.pone.0234702","volume":"15","author":"GN Okoli","year":"2020","unstructured":"Okoli GN, Lam OLT, Racovitan F, Reddy VK, Righolt CH, Neilson C, et al. Seasonal influenza vaccination in older people: A systematic review and meta-analysis of the determining factors. PLoS ONE. 2020;15(6):e0234702.","journal-title":"PLoS ONE"},{"key":"25591_CR29","unstructured":"Autoridade Nacional de Comunica\u00e7\u00f5es. Indicadores de servi\u00e7os de comunica\u00e7\u00f5es [Communications service indicators] [Internet]. 2025 [cited 2025 Oct 19]. Available from: https:\/\/www.anacom-consumidor.pt\/estatisticas-indicadores-servicos"},{"issue":"6","key":"25591_CR30","doi-asserted-by":"publisher","first-page":"1612","DOI":"10.1080\/21645515.2020.1846397","volume":"17","author":"SM Sherman","year":"2021","unstructured":"Sherman SM, Smith LE, Sim J, Aml\u00f4t R, Cutts M, Dasch H, et al. COVID-19 vaccination intention in the UK: results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey. Hum Vaccin Immunother. 2021;17(6):1612\u201321.","journal-title":"Hum Vaccin Immunother"},{"key":"25591_CR31","unstructured":"World Health Organization. Behavioural and social drivers of vaccination: tools and practical guidance for achieving high uptake [Internet]. Geneva. 2022. Available from: https:\/\/iris.who.int\/bitstream\/handle\/10665\/354459\/9789240049680-eng.pdf?sequence=1"},{"issue":"2","key":"25591_CR32","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77\u2013101.","journal-title":"Qual Res Psychol"},{"key":"25591_CR33","unstructured":"PORDATA. Popula\u00e7\u00e3o residente: total e por grandes grupos et\u00e1rios (%) [Internet]. 2023 [cited 2024 Jan 11]. Available from: https:\/\/www.pordata.pt\/portugal\/populacao+residente+total+e+por+grandes+grupos+etarios+(percentagem)-3018-253437"},{"issue":"10","key":"25591_CR34","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.3390\/vaccines10101595","volume":"10","author":"RF Nuwarda","year":"2022","unstructured":"Nuwarda RF, Ramzan I, Weekes L, Kayser V. Vaccine hesitancy: contemporary issues and historical background. Vaccines. 2022;10(10):1595.","journal-title":"Vaccines"},{"key":"25591_CR35","doi-asserted-by":"publisher","first-page":"104241","DOI":"10.1016\/j.ijnurstu.2022.104241","volume":"131","author":"MDJ Peters","year":"2022","unstructured":"Peters MDJ. Addressing vaccine hesitancy and resistance for COVID-19 vaccines. Int J Nurs Stud. 2022;131:104241.","journal-title":"Int J Nurs Stud"},{"key":"25591_CR36","doi-asserted-by":"publisher","unstructured":"Ebrahimi OV, Johnson MS, Ebling S, Amundsen OM, Hals\u00f8y \u00d8, Hoffart A et al. Risk, trust, and flawed assumptions: Vaccine hesitancy during the COVID-19 pandemic. Front Public Heal [Internet]. 2021;9:700213. Available from: https:\/\/www.frontiersin.org\/journals\/public-health\/articles\/https:\/\/doi.org\/10.3389\/fpubh.2021.700213","DOI":"10.3389\/fpubh.2021.700213"},{"issue":"9","key":"25591_CR37","doi-asserted-by":"publisher","first-page":"2623","DOI":"10.4161\/21645515.2014.970076","volume":"10","author":"K Corace","year":"2014","unstructured":"Corace K, Garber G. When knowledge is not enough: changing behavior to change vaccination results. Hum Vaccin Immunother. 2014;10(9):2623\u20134.","journal-title":"Hum Vaccin Immunother"},{"key":"25591_CR38","doi-asserted-by":"crossref","unstructured":"Gualano MR, Santoro PE, Borrelli I, Rossi MF, Amantea C, Tumminello A et al. Employee participation in workplace vaccination campaigns: A systematic review and meta-analysis. Vaccines [Internet]. 2022;10(11). Available from: https:\/\/www.mdpi.com\/2076-393X\/10\/11\/1898","DOI":"10.3390\/vaccines10111898"},{"key":"25591_CR39","doi-asserted-by":"crossref","unstructured":"Ofstead CL, Sherman BW, Wetzler HP, Langlay AMD, Mueller NJ, Ward JM et al. Effectiveness of worksite interventions to increase Influenza vaccination rates among employees and families. J Occup Environ Med [Internet]. 2013;55(2):156\u201363. Available from: https:\/\/www.jstor.org\/stable\/48510247","DOI":"10.1097\/JOM.0b013e3182717d13"},{"key":"25591_CR40","doi-asserted-by":"crossref","unstructured":"\u0160t\u011bp\u00e1nek L, Jano\u0161\u00edkov\u00e1 M, Nakl\u00e1dalov\u00e1 M, Ivanov\u00e1 K, Mac\u00edk J, Borikov\u00e1 A et al. Motivation for COVID-19 vaccination in priority occupational groups: a cross-sectional survey. Int J Environ Res Public Health [Internet]. 2021;18(21). Available from: https:\/\/www.mdpi.com\/1660-4601\/18\/21\/11726","DOI":"10.3390\/ijerph182111726"},{"key":"25591_CR41","doi-asserted-by":"publisher","unstructured":"Soto-V\u00e1squez AD, Gonzalez AA, Garza Garza E, Shi W, Garcia N. The cultural influence of familismo in prompting vaccination against COVID-19 among U.S. latina\/o\/x border residents. Health Commun [Internet]. 2025;40(4):563\u201373. Available from: https:\/\/doi.org\/10.1080\/10410236.2024.2353418","DOI":"10.1080\/10410236.2024.2353418"},{"key":"25591_CR42","doi-asserted-by":"crossref","unstructured":"Silva TM, Estrela M, Roque V, Gomes ER, Figueiras A, Roque F, et al. Perceptions, knowledge and attitudes about COVID-19 vaccine hesitancy in older Portuguese adults. Age Ageing. 2022;51(3):1-9.","DOI":"10.1093\/ageing\/afac013"},{"issue":"49","key":"25591_CR43","doi-asserted-by":"publisher","first-page":"6649","DOI":"10.1016\/j.vaccine.2014.09.039","volume":"32","author":"E Dub\u00e9","year":"2014","unstructured":"Dub\u00e9 E, Gagnon D, Nickels E, Jeram S, Schuster M. Mapping vaccine hesitancy\u2014Country-specific characteristics of a global phenomenon. Vaccine. 2014;32(49):6649\u201354.","journal-title":"Vaccine"},{"issue":"26","key":"25591_CR44","doi-asserted-by":"publisher","first-page":"3520","DOI":"10.1016\/j.vaccine.2021.04.062","volume":"39","author":"LAB Nicholls","year":"2021","unstructured":"Nicholls LAB, Gallant AJ, Cogan N, Rasmussen S, Young D, Williams L. Older adults\u2019 vaccine hesitancy: psychosocial factors associated with influenza, pneumococcal, and shingles vaccine uptake. Vaccine. 2021;39(26):3520\u20137.","journal-title":"Vaccine"},{"key":"25591_CR45","doi-asserted-by":"crossref","unstructured":"Peschke M, Hagel S, Rose N, Pletz MW, Steiner A. Seasonal influenza vaccination at a German university hospital: distinguishing barriers between occupational groups. Front Med. 2022;9.","DOI":"10.3389\/fmed.2022.873231"},{"key":"25591_CR46","doi-asserted-by":"crossref","unstructured":"Pavlovic D, Sahoo P, Larson HJ, Karafillakis E. Factors influencing healthcare professionals\u2019 confidence in vaccination in Europe: a literature review. Hum Vaccin Immunother. 2022;18(1):2041360.","DOI":"10.1080\/21645515.2022.2041360"},{"key":"25591_CR47","doi-asserted-by":"publisher","first-page":"100219","DOI":"10.1016\/j.jvacx.2022.100219","volume":"12","author":"A Alasmari","year":"2022","unstructured":"Alasmari A, Larson HJ, Karafillakis E. A mixed methods study of health care professionals\u2019 attitudes towards vaccination in 15 countries. Vaccine X. 2022;12:100219.","journal-title":"Vaccine X"},{"key":"25591_CR48","doi-asserted-by":"crossref","unstructured":"Estrela M, Magalh\u00e3es Silva T, Roque V, Rebelo Gomes E, Roque F, Herdeiro MT, et al. What determines health professionals\u2019 COVID\u201019 vaccine hesitancy? A nationwide study. Eur J Clin Invest. 2022;52(7):e13785","DOI":"10.1111\/eci.13785"},{"issue":"4","key":"25591_CR49","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1093\/eurpub\/ckad101","volume":"33","author":"TE Lanza","year":"2023","unstructured":"Lanza TE, Paladini A, Marziali E, Gianfredi V, Blandi L, Signorelli C, et al. Training needs assessment of European frontline health care workers on vaccinology and vaccine acceptance: a systematic review. Eur J Public Health. 2023;33(4):591\u20135.","journal-title":"Eur J Public Health"},{"issue":"4","key":"25591_CR50","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1080\/21645515.2015.1101524","volume":"12","author":"DM MacDougall","year":"2016","unstructured":"MacDougall DM, Halperin SA. Improving rates of maternal immunization: challenges and opportunities. Hum Vaccin Immunother. 2016;12(4):857\u201365.","journal-title":"Hum Vaccin Immunother"},{"issue":"11","key":"25591_CR51","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.3390\/vaccines11111697","volume":"11","author":"V Gianfredi","year":"2023","unstructured":"Gianfredi V, Berti A, Stefanizzi P, D\u2019Amico M, De Lorenzo V, Moscara L, et al. COVID-19 vaccine knowledge, attitude, acceptance and hesitancy among pregnancy and breastfeeding: systematic review of hospital-based studies. Vaccines. 2023;11(11):1697.","journal-title":"Vaccines"},{"issue":"1","key":"25591_CR52","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1007\/s11845-023-03428-0","volume":"193","author":"SM Kelly","year":"2024","unstructured":"Kelly SM, Bracken O, Bholah T, Crosby DA. Uptake rates and attitudes to influenza and COVID-19 vaccination in pregnancy \u2013 a prospective cohort study. Ir J Med Sci. 2024;193(1):289\u201393.","journal-title":"Ir J Med Sci"},{"issue":"3","key":"25591_CR53","doi-asserted-by":"publisher","first-page":"e0282525","DOI":"10.1371\/journal.pone.0282525","volume":"18","author":"B Nichol","year":"2023","unstructured":"Nichol B, McCready JL, Steen M, Unsworth J, Simonetti V, Tomietto M. Barriers and facilitators of vaccine hesitancy for COVID-19, influenza, and pertussis during pregnancy and in mothers of infants under two years: an umbrella review. PLoS ONE. 2023;18(3):e0282525.","journal-title":"PLoS ONE"},{"issue":"2","key":"25591_CR54","doi-asserted-by":"publisher","first-page":"e2361","DOI":"10.1016\/j.ajog.2021.08.007","volume":"226","author":"H Blakeway","year":"2022","unstructured":"Blakeway H, Prasad S, Kalafat E, Heath P, Ladhani SN, Le Doare K, et al. COVID-19 vaccination during pregnancy: coverage and safety. Am J Obstet Gynecol. 2022;226(2):e2361\u201323614.","journal-title":"Am J Obstet Gynecol"},{"issue":"20","key":"25591_CR55","doi-asserted-by":"publisher","first-page":"2751","DOI":"10.1016\/j.vaccine.2018.04.013","volume":"36","author":"KA Bisset","year":"2018","unstructured":"Bisset KA, Paterson P. Strategies for increasing uptake of vaccination in pregnancy in high-income countries: A systematic review. Vaccine. 2018;36(20):2751\u20139.","journal-title":"Vaccine"},{"issue":"47","key":"25591_CR56","doi-asserted-by":"publisher","first-page":"6420","DOI":"10.1016\/j.vaccine.2015.08.046","volume":"33","author":"RJ Wilson","year":"2015","unstructured":"Wilson RJ, Paterson P, Jarrett C, Larson HJ. Understanding factors influencing vaccination acceptance during pregnancy globally: A literature review. Vaccine. 2015;33(47):6420\u20139.","journal-title":"Vaccine"},{"issue":"1","key":"25591_CR57","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1186\/s12884-023-05505-9","volume":"23","author":"V Widdershoven","year":"2023","unstructured":"Widdershoven V, Reijs RP, Eskes A, Verhaegh-Haasnoot A, Hoebe CJPA. Acceptance of vaccination against pertussis, COVID-19 and influenza during pregnancy: a cross-sectional study. BMC Pregnancy Childbirth. 2023;23(1):219.","journal-title":"BMC Pregnancy Childbirth"},{"key":"25591_CR58","doi-asserted-by":"publisher","unstructured":"Sheeran P. Intention\u2014behavior relations: A conceptual and empirical review. Eur Rev Soc Psychol [Internet]. 2002;12(1):1\u201336. Available from: https:\/\/doi.org\/10.1080\/14792772143000003","DOI":"10.1080\/14792772143000003"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-025-25591-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-025-25591-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-025-25591-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T13:51:08Z","timestamp":1769781068000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12889-025-25591-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,28]]},"references-count":58,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["25591"],"URL":"https:\/\/doi.org\/10.1186\/s12889-025-25591-y","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,28]]},"assertion":[{"value":"28 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Council of the Lisbon School of Nursing, with the Reference number: 3089\/2023. All study procedures were in accordance with the 1964 Helsinki declaration and its later amendments.\u00a0Participants were informed about the study goals and procedures, and confidentiality and anonymity were ensured prior to participation. Informed consent was obtained from all participants prior to data collection.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"395"}}