Do Thai Physicians Recommend Seasonal Influenza Vaccines to Pregnant Women? A Cross-Sectional Survey of Physicians’ Perspectives and Practices in Thailand

Abstract

BackgroundPhysicians play a major role in influencing acceptance and uptake of vaccines. However, little is known about physicians’ perspectives on influenza vaccination of pregnant women in Thailand, for whom vaccine coverage is estimated at <1%.MethodIn 2013, a self-administered questionnaire on physicians’ perceptions, attitudes and practices related to influenza vaccination for pregnant women was distributed to 1,134 hospitals with an antenatal care clinic (ANC) in Thailand. At each hospital, one physician working at the ANC completed the survey. Predictors of routine recommendation of influenza vaccine were analyzed utilizing log-binomial regression.ResultsA total of 580 (51%) complete responses were received from physicians practicing at ANCs. A favorable attitude towards vaccination was expressed by 436 (75%) physicians, however only 142 (25%) reported routinely recommending influenza vaccine to pregnant women in their current practice. Physicians were more likely to recommend influenza vaccine routinely when they had more than three years of practice (prevalence ratio [PR] 1.9, 95% CI 1.2–2.3), had treated pregnant women for influenza (PR 1.8, 95% CI 1.3–2.7), perceived the influenza vaccine to be effective (moderate level: PR 1.6, 95% CI 1.1–2.4; high level: PR 1.9, 95% CI 1.3–2.9) and were aware of the Ministry of Public Health’s (MOPH) recommendation of influenza vaccination in pregnancy (PR 1.3, 95% CI 1.1–1.7). Vaccine not being available, perception that policy was ambiguous and lack of awareness of MOPH recommendations were the most commonly cited barriers to routine recommendation of influenza vaccine.ConclusionDespite a national policy to vaccinate pregnant women for influenza, only 25% of Thai physicians working in ANCs routinely recommend vaccination. Strategies are needed to increase vaccine availability and free vaccine services, address clinician concerns over vaccine effectiveness and expand healthcare provider awareness of MOPH recommendations.

Coverage and determinants of influenza vaccine among pregnant women: a cross-sectional study

“…Healthcare providers who are more knowledgeable [36, 37] and confident [38, 39] about the influenza vaccine are more likely to recommend vaccination and obtain high coverage among expecting mothers. In Singapore, qualitative studies have revealed limited influenza vaccine acceptance among healthcare professionals [40, 41].…”

Predictors for influenza vaccination among Thai pregnant woman: The role of physicians in increasing vaccine uptake

“…In a recent study conducted in Thailand, Praphasiri et al examined the association of characteristics of obstetricians and gynecologists and their reported practice in recommending influenza vaccine to pregnant women using a mail survey method . They reported that physicians were more likely to routinely recommend influenza vaccine to pregnant women when they were aware of the MOPH policy of influenza vaccination in pregnancy.…”

“…Years of practice, median (IQR) to pregnant women using a mail survey method. 52 They reported that physicians were more likely to routinely recommend influenza vaccine to pregnant women when they were aware of the MOPH policy of influenza vaccination in pregnancy. Consistently, all of our frequent recommenders stated they agreed with the MOPH policy.…”

Free vaccinations and clinical history takings of the vaccine recipients: reliable or not?

“…There is no doubt that some of adverse side-effects of a vaccine observed in the developing countries might be due to disguising of the clinical information by the patients. In Thailand, the focus is on promoting the availability of free influenza vaccination [6]; however, there is no additional concern regarding the way to control the safety use of the vaccine. In fact, the unreliability of the clinical history regarding vaccination is usually problematic.…”