AIM: Maternal immunization is essential for preventing severe influenza and pertussis in pregnant women and young infants. Despite clear recommendations, uptake in Greece remains suboptimal, and evidence on effective antenatal interventions is limited. This study evaluated the impact of a structured counselling programme on maternal influenza and pertussis vaccination coverage. METHODS: A prospective before-after study was conducted among 595 pregnant women delivering at a regional perinatal centre across two influenza seasons (2022-2023 and 2024-2025). During the pre-intervention period, routine antenatal care lacked standardized counselling. The intervention included provider-initiated structured counselling supported by an educational leaflet and routine prescription of both vaccines. Vaccination status was confirmed postpartum. Multivariable logistic regression identified determinants of uptake. RESULTS: Antenatal counselling increased from 43.1% to 74.2%. Influenza vaccination rose from 38.5% to 61.4%, pertussis from 33.8% to 65.5% and combined uptake more than doubled (27.0% to 58.4%). Structured counselling significantly improved adherence (OR 8.7; 95% CI 5.236-14.493). Fear of vaccine-related risks remained the main reason for refusal, though less frequently reported post-intervention. CONCLUSIONS: Structured antenatal counselling substantially improved maternal influenza and pertussis vaccination coverage. Integrating standardized counselling and routine prescription into antenatal care aligns with international recommendations and may strengthen maternal immunization efforts in Greece.
Drougia et al. (2026) studied this question.