Influenza vaccination in pregnancy: vaccine uptake, maternal and healthcare providers’ knowledge and attitudes. A quantitative study

Abstract

BackgroundInfluenza during pregnancy is a potentially life threatening illness. There are limited data on influenza vaccination uptake and determinants of uptake in Irish obstetric populations.AimTo determine the uptake of influenza vaccination during pregnancy; determinants of vaccination uptake; knowledge, attitudes, and concerns of postnatal women; and knowledge and attitudes of healthcare professionals (HCPs) surrounding vaccination.Design & settingA quantitative study of postnatal women attending the Rotunda Hospital, a tertiary referral maternity hospital in Dublin, Ireland. A separate quantitative study conducted by the North Dublin City GP Training Programme surveyed GPs, pharmacists, and Rotunda Hospital clinical staff.MethodA paper-based survey was distributed to postnatal women. HCPs completed the survey via the online tool Survey Monkey.Results330 patient surveys were disseminated, with a 60.0% response rate. Of 198 responders, 109 (55.1%) were vaccinated against influenza. Non-professionals were less likely to be vaccinated (adjusted odds ratio [aOR] 0.29, 95% confidence interval [CI] = 0.09 to 0.89). Vaccination in previous pregnancy (aOR 5.2, 95% CI = 1.69 to 15.62) and information from an HCP were strongly associated with vaccination (aOR 12.8, 95% CI = 2.65 to 62.5). There was a 20.2% (n = 1180) response rate among HCPs. More GPs felt that it was their role to discuss vaccination (92.9%; n = 676), and offer to vaccinate women (91.7%; n = 666) than any other HCP.ConclusionProvision of information about the importance of vaccination against influenza and pertussis during pregnancy by HCPs and their consistent recommendations in support of vaccination were key determinants of vaccine uptake during pregnancy. The sociodemographic determinants of a woman’s vaccination status should be addressed in health promotion campaigns. Education of HCPs may address knowledge gaps surrounding vaccination.

Factors that influence vaccination decision-making among pregnant women: A systematic review and meta-analysis

“…For pandemic vaccine the recommendation increased the odds of antenatal H1N1 vaccine uptake by six times (OR 6.76, 95% CI 3.12–14.64, 5 studies, 6898women) [ 42 – 46 ]. The odds of pregnant women receiving season influenza vaccination were five-times higher if they had general information about the vaccine (OR 5.68, 95% CI 1.53–21.13,4 studies, 1193 women) [ 22 , 27 , 31 , 47 ]. Similarly, the odds of being vaccinated were three-times higher (OR 3.68, 95% CI 2.12–6.38, 4 studies, 3583 women) [ 37 , 40 , 48 , 49 ] among pregnant women who knew there was a national vaccination policy in place versus women who were unaware.…”

“…Pregnant women who received a seasonal influenza vaccination during a prior pregnancy had nine-times higher odds of accepting a pandemic influenza vaccine in their current pregnancy than those who did not vaccinate in a prior pregnancy (OR 9.12, 95% CI 1.99–41.76, 2 studies, 442 women) [ 43 , 53 ]. There was no evidence to suggest an association between prior maternal vaccination and season influenza vaccinations (OR 1.51, 95% CI 0.71–3.24, 3 studies, 2,339 women) [ 21 , 22 , 47 ].…”

Knowledge and attitudes towards influenza and influenza vaccination among pregnant women in Kenya

“…Much as we did not observe any significant association between healthcare provider recommendation for vaccination in general and willingness to receive influenza vaccine, ANC settings with government healthcare providers still represent an opportunity to provide women with information on influenza vaccines. To capitalize on this opportunity and raise awareness levels of influenza and influenza vaccines among pregnant women in Kenya and in other countries planning adoption of influenza vaccination in pregnancy, healthcare providers are best placed to communicate influenza vaccine information [36] , [38] , [39] , [40] .…”

Incidence, risk factors and impact of seasonal influenza in pregnancy: A national cohort study

“…The most commonly cited reasons for not being immunised include perceptions of risk of influenza and concern over effectiveness or safety of the immunization [ 33 – 35 ]. Characteristics of women associated with an increased likelihood of receiving seasonal influenza immunization are White British ethnicity [ 35 ], professional employment and education [ 33 , 36 ], immunization in a previous pregnancy and receiving information around immunization from a healthcare professional [ 36 ]. Similar characteristics were associated with uptake of pandemic flu vaccine in 2009 [ 37 , 38 ].…”