Trust, emotions and risks: Pregnant women's perceptions, confidence and decision-making practices around maternal vaccination in France

Maternal vaccination is an important strategy to reduce maternal and newborn mortality and morbidity. Yet, vaccination uptake is suboptimal in many countries, including France. This mixed-method study aimed to identify factors influencing maternal vaccination, exploring pregnant women's perceptions, confidence, and decision-making processes in France. Maternal vaccination uptake was positively associated with awareness of maternal vaccines, confidence in vaccine effectiveness and receiving a recommendation from a healthcare professional. A trusting relationship with healthcare professionals was observed as crucial for women during pregnancy. Even if women considered themselves as sole decision-makers, healthcare professionals' role in decision-making was viewed as substantial. Pregnancy can be a complex time for assessing risks, which was evident in the strong emotional reactions to maternal vaccination and anxieties about safety. As new maternal vaccines are developed, it is crucial to consider women's values, risk perceptions and emotions in the development of strategies to support acceptance of maternal vaccination. (c) 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

Automated summary

Maternal vaccination uptake is influenced by pregnant women's awareness of vaccines, confidence in vaccine effectiveness, and healthcare professionals' recommendations. Trusting relationships with healthcare providers are crucial for pregnant women, even if they see themselves as sole decision-makers.