Influenza Vaccination among Pregnant Women: Patient Beliefs and Medical Provider Practices (original) (raw)
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Vaccine, 2020
Introduction: WHO recommends influenza vaccination for pregnant women and health providers (HPs), yet global uptake for both is persistently low. Research suggests that HPs greatly influence uptake of influenza vaccine in pregnant women. Our review studies HPs' recommendation of influenza vaccine to pregnant women, determinants and barriers to recommendation, and the role that HPs may play in global influenza vaccine coverage. Methods: We undertook a comprehensive global review of literature relating to HPs' recommendation of seasonal influenza vaccines to pregnant women and the determinants and barriers to recommendation and how this may vary by country and context. We evaluated data from each study including frequency of HP recommendation, vaccine coverage, determinants and barriers to recommendation, and the odds of recommending. We tracked the frequency of determinants and barriers to recommendation in heat maps and organized data by world regions and income classifications. Results: From 32 studies in 15 countries, we identified 68 determinants or barriers to HPs' recommendation. Recommendation rates were highest (77%) in the Americas and lowest in South East Asia (18%). A HP's own influenza vaccine status was a main determinant of recommendation in multiple country contexts and from different provider types. Financial barriers to recommendation were present in higherincome countries and policy-related barriers were highlighted in lower-income countries. HP perceptions of safety, efficacy, and the utility of vaccine were the most frequently cited barriers, relevant in almost every context. Conclusions: HP recommendation is important to influenza vaccine implementation in pregnant women. A HP's own status is an important recommendation determinant in multiple contexts. Vaccine program implementation plans should consider the impact of HPs' knowledge, awareness and vaccine confidence on their own uptake and recommendation practices, as well as on the uptake among pregnant women. Addressing safety and efficacy concerns is relevant in all contexts for HPs and pregnant women.
Saudi Pharmaceutical Journal, 2017
The purpose of the study was to assess the knowledge, attitudes, beliefs, and factors associated with the uptake of the influenza (flu) vaccination in women within Saudi Arabia during their pregnancy period. Methods: A cross-sectional prospective survey was conducted on 1085 pregnant women at the antenatal clinic over a period of 6 weeks with the provision of influenza vaccination. The questionnaire collected demographic and other data; it included 12 questions on their general knowledge and assessed their attitude toward influenza vaccination, and their awareness of vaccine risk and the potential benefits during pregnancy. The knowledge score obtained was then calculated and compared. Results: A total of 998 patients took part in the questionnaire with a response rate of 92%. There was poor awareness that the flu vaccine is safe to administer during pregnancy (130, 13.1%) and that all pregnant women should receive the flu vaccine (190, 19.1%). Pregnant women with flu vaccine knowledge score of 65 (range 0-12) were significantly less likely to take the vaccine (OR 3.78, 95% CI 2.68-5.26, p < 0.001). There was a low uptake of the vaccine (178, 18.1%) and only 29 (3.0%) had previously been offered the flu vaccine by any doctor during their pregnancy. In addition, 255 (25.8%) were against taking the flu vaccine during pregnancy. Conclusion: The knowledge and uptake of the influenza vaccine among Saudi pregnant women are low. One quarter was against the vaccine during pregnancy. Very few
Assiut Scientific Nursing Journal
Background: Seasonal influenza during pregnancy is a potentially life-threatening illness. It is associated with an increased risk for both mother and fetus, as; respiratory and cardio-pulmonary hospitalization, pre-term delivery, fetal distress, and death. The current study aims to assess knowledge and beliefs regarding seasonal influenza vaccine among pregnant women attending antenatal clinics. Methods: A descriptive correlational research design was adopted for this study to achieve the study aim. Tool: Three tools were used to collect the data; 1) structured interviewing questionnaire schedule, 2) seasonal Influenza knowledge assessment tool, and 3) influenza vaccine beliefs scale. Sample: A purposive of 160 pregnant women was enrolled in the study. Setting: the study was conducted at the outpatient antenatal clinics, maternity hospital, Cairo University, Egypt. Results: The mean age of the study sample was 29.98 ± 6.107 years. About 45.6% of them had primary and secondary education with more than half of the study sample were working (51.9%). More than half of the study sample (51.9%) had a sufficient level of knowledge with a positive beliefs regarding seasonal influenza vaccine during pregnancy. The barrier of pregnant women not taking the vaccine was; expensive; women not welling and fears from safety of the vaccine. Conclusions: Pregnant women had a sufficient level of knowledge and positive beliefs regarding influenza vaccination during pregnancy. Recommendations: These findings are important in tailoring educational programs and addressing the training needs of increase awareness regarding seasonal influenza during pregnancy for all women attending outpatient clinics. Also, the obstetricians should be highlighted the need for a national policy for the use of vaccines during pregnancy.
Influenza vaccination acceptance among diverse pregnant women and its impact on infant immunization
Human Vaccines & Immunotherapeutics, 2013
Objective: We examined pregnant women's likelihood of vaccinating their infants against seasonal influenza via a randomized message framing study. Using Prospect Theory, we tested gain-and loss-frame message effects and demographic and psychosocial correlates of influenza immunization intention. We also explored interactions among pregnant women who viewed "contagion" to understand cultural influences on message perception. Results: The study population (n = 261) included many lower income (≤$20 000/yearly household earnings) pregnant participants (69.2%, n = 171) inclusive of Black/african americans (88.5%, n = 230), hispanic/Latinas (7.3%, n = 19), and Other/Multicultural women (4.2%, n = 11). Both gain [OR = 2.13, 90% cI: (1.120, 4.048)] and loss-frame messages [OR = 2.02, 90% cI: (1.083, 3.787)] were significantly associated with infant influenza vaccination intention compared with the control condition. Intention to immunize against influenza during pregnancy had a strong effect on intent to immunize infants [OR = 10.83, 90%cI: (4.923, 23.825)]. Those who had seen the feature film "contagion" (n = 54, 20.69%) viewed gain-and loss-framed messages as appealing (x 2 = 6.03, p = 0.05), novel (x 2 = 6.24, p = 0.03), and easy to remember (x 2 = 16.33, P = 0.0003). Conclusions: In this population, both gain-and loss-framed messages were positively associated with increased maternal intent to immunize infants against influenza. Message resonance was enhanced among those who saw the film "contagion." additionally, history of immunization was strongly associated with infant immunization intention. Methods: Pregnant women ages 18-50 participated in a randomized message framing study from september 2011 through May 2012 that included exposure to intervention or control messages, coupled with questionnaire completion. Venue-based sampling was used to recruit racial and ethnic minority female participants at locations throughout atlanta, Georgia. Bivariate and multivariate analyses were conducted to evaluate key outcomes.
Journal of obstetrics and gynaecology Canada, 2009
Introduction: We wished to assess pregnant women's knowledge of influenza, vaccine safety during pregnancy and breast feeding, and the recommendations for use of the influenza vaccine in pregnancy. Methods: We performed a cross-sectional survey of postpartum women during influenza season in 2006. Results: Pregnant women's overall knowledge of these subjects was poor. Most women (95%) knew that influenza is highly contagious, but almost 90% incorrectly believed that pregnant women have the same risk of complications as non-pregnant women. Only one half of the women were aware of national recommendations for vaccination during pregnancy and that the vaccine is safe during pregnancy and breast feeding, and 80% incorrectly believed that the vaccine can cause birth defects. Only 20% of women had been offered the vaccine during the current pregnancy or a prior pregnancy. Conclusions: Pregnant women's knowledge about influenza vaccine recommendations and safety during pregnancy is poor. There is substantial room for improvement among prenatal care providers in both patient education and offering the vaccine.
Maternal and Child Health Journal, 2000
The objective of this study was to explore pregnant and recently pregnant women’s perceptions of influenza vaccine and antivirals during the 2009 H1N1 pandemic. We conducted 18 focus groups with pregnant and recently pregnant women in three US cities in September 2009. Participants were segmented into groups by insurance status (no or public insurance vs. private insurance), vaccine attitudes (higher vs. lower likelihood of acceptance of any vaccines, not only influenza vaccines), and parity (first child vs. other children in the home) based on information they provided on the screening questionnaire at the time of recruitment. We found that women are not well informed about influenza vaccinations and antiviral medicine and have significant concerns about taking them during pregnancy. An interest in their infant’s well-being, however, can be strong motivation to adopt preventive recommendations, including vaccination. A woman’s health care provider is a highly trusted source of information about the 2009 H1N1. Pregnant women have unique communication needs for influenza. Messages directing pregnant women to adopt public health recommendations, particularly for vaccination or prophylactic medication should include a detailed description of the benefits or lack of risk to the fetus and the safety of breastfeeding. Additionally, messages should recognize that pregnant women are taught to be selective about taking medication and provide a clear rationale for why the medicine or vaccine is necessary.
Human Vaccines & Immunotherapeutics, 2020
Vaccine coverage for maternal vaccines is suboptimal; only about half of pregnant women received influenza and Tdap vaccines in 2018. We explored knowledge, attitudes, beliefs, intentions, and trust regarding maternal and infant vaccines among pregnant women. Between June 2017 and July 2018, we surveyed 2196 pregnant women recruited from geographically and socio-demographically diverse prenatal care practices in Georgia and Colorado (56% response rate). Fifty-six percent of pregnant women intended to receive both influenza and Tdap vaccines during pregnancy and 68% intended to vaccinate their baby with all recommended vaccines on time. Attitudinal constructs associated with intention to vaccinate include confidence in vaccine safety (ORs: 16-38) and efficacy (ORs: 4-19), perceived risk of vaccine-preventable diseases (ORs: 2-6), social norms (ORs: 4-10), and trust in sources of vaccine information. Women pregnant with their first child were less likely than women who had prior children to intend to vaccinate themselves and their children, more likely to be unsure about their intentions to receive both maternal and infant vaccines, and less likely to report feeling they had enough knowledge or information about vaccines and vaccine safety (p < .01). This demonstrates an opportunity for vaccine education to increase vaccine confidence and informed decision-making, especially among first-time pregnant women.
Vaccine, 2007
This cross-sectional study of 340 obstetrics/gynecology, 123 neonatology, and 244 pediatric health care workers (HCWs) was designed to evaluate compliance with recommendations concerning the use of influenza vaccine during pregnancy and among pediatric subjects. The results clearly show that only a marginal number of the HCWs in all three fields currently recommend vaccine use for pregnant women and healthy young children. Moreover, all of the HCWs were seriously deficient in terms of their general knowledge of influenza prevention and their own personal vaccination coverage was low. Extensive and sustained efforts to overcome cultural limitations concerning influenza and its prevention are urgently required among HCWs caring for women and children in order to ensure effective compliance with the current recommendations.