Vaccination coverage during pregnancy and factors associated with refusal of recommended vaccinations: An Italian cross sectional study

•Adherence to the influenza vaccine among Italian pregnant women is low.•There is a reduced perception of the risks of influenza in pregnancy.•The insufficient information received was the main reason for missing Tdap vaccination.•The main reason behind COVID-19 vaccine refusal was fear of side effects on the fetus.•There is a significant difference in vaccination coverage between Italians and foreigner patients. The vaccines recommended during pregnancy are the Tdap, the influenza vaccine, and, during the SARS-CoV-2 pandemic, the vaccine against COVID-19. This survey aimed at determining vaccination coverage among pregnant women and adverse events, reasons for vaccine refusal, and factors associated with vaccine uptake. A single-center cross-sectional study was conducted on women who delivered between March and April 2022 at Careggi University Hospital in Florence, Italy. Information on the vaccinations (Tdap, influenza and COVID-19) received during pregnancy were collected through in-person interviews. Among 307 enrolled women (response rate 99 % on a study population of 310 eligible women), 74 % of patients were vaccinated with Tdap, 82 % against COVID-19, and only 33 % against influenza. Vaccination coverage for Tdap and COVID-19 was significantly higher among Italian than foreign patients (80 % vs 51 %, p