Low Influenza Vaccine Awareness and Uptake Among Pregnant Women in Split-Dalmatia County, Croatia: A Cross-sectional Survey.

OBJECTIVE: Pregnant women face increased risks from influenza complications, underscoring the importance of vaccination. This study evaluated knowledge and attitudes about influenza vaccination and self-reported vaccination rates among pregnant women in Split-Dalmatia County, Croatia. METHODS: A cross-sectional study was conducted from March to July 2020 in primary healthcare gynecological clinics in Split, Croatia. A convenience sample of pregnant women completed an anonymous 33-question survey after providing informed consent. Data were analyzed with a chi-square test, Fisher's exact test, or Kruskal-Wallis test, as appropriate. RESULTS: Among 323 participants, only 10 (3.2%) received the influenza vaccine during pregnancy. Most respondents (96.3%) reported that healthcare providers did not offer them influenza vaccine. Insufficient knowledge about influenza vaccination was observed, with a median score of 38.46 (IQR = 23.08-53.85) out of 100. Higher education was significantly associated with better knowledge about influenza vaccination (P = 0.006), while age was not (P = 0.441). The primary reason cited for not getting vaccinated was a lack of information about the influenza vaccine (n = 144, 46%). Media sources such as radio, television, and the Internet were the most common sources of vaccine information (n = 89, 40%), while only a small fraction (n = 15, 6.7%) received information from their gynecologist. CONCLUSIONS FOR PRACTICE: Low self-reported vaccination rates among pregnant women in Split-Dalmatia County were primarily due to insufficient awareness and inadequate information from healthcare professionals. Improved education and proactive vaccine promotion by healthcare providers are critical to addressing this gap.