Knowledge, attitudes and beliefs related to seasonal influenza vaccine among pregnant women in Thailand

Abstract

Background In 2009, Thailand recommended pregnant women be prioritized for influenza vaccination. Vaccine uptake among Thai pregnant women is lower than other high-risk groups. Methods During December 2012-April 2013, we conducted a cross-sectional survey of a convenience sample of Thai pregnant women aged ≥15 years attending antenatal clinics at public hospitals in 8 of 77 provinces. A self-administered questionnaire covered knowledge, attitudes, and beliefs related to influenza vaccination using the Health Belief Model. We examined factors associated with willingness to be vaccinated using log-binomial regression models. Results The survey was completed by 1,031 (96%) of 1,072 pregnant women approached. A total of 627 (61%) women had heard about influenza vaccine and were included in the analysis, of whom 262 (42%) were willing to be vaccinated, 155 (25%) had received a healthcare provider recommendation for influenza vaccination and 25 (4%) had received the influenza vaccine during the current pregnancy. In unadjusted models, high levels of perceptions of susceptibility (prevalence ratio [PR] 1.5, 95% CI 1.2–2.0), high levels of belief in the benefits of vaccination (PR 2.3, 95% CI 1.7–3.1), moderate (PR 1.7, 95% CI 1.2–2.3) and high (PR 3.4, 95% CI 2.6–4.5) levels of encouragement by others to be vaccinated (i.e., cues to action) were positively associated with willingness to be vaccinated. Moderate (PR 0.5, 95% CI 0.4–0.7) and high levels of (PR 0.5, 95% CI 0.4–0.8) perceived barriers were negatively associated with willingness to be vaccinated. In the final adjusted model, only moderate (PR 1.5, 95% CI 1.1–2.0) and high levels of cues to action (PR 2.7, 95% CI 2.0–3.6) were statistically associated with willingness to be vaccinated. Conclusion Cues to action were associated with willingness to be vaccinated and can be used to inform communication strategies during the vaccine campaign to increase influenza vaccination among Thai pregnant women.

Seasonal influenza vaccination in pregnant women: knowledge, attitudes, and behaviors in Italy

“…This value is almost identical to the 21.6% found in the United States among pregnant minority women [47]. By contrast, higher values have been observed in the already mentioned survey in Thailand with 42% of the women who reported being willing to receive the seasonal influenza vaccine [26], in the United States 82.8% said they would be immunized if recommended by their physician [23], and in Pakistan 87% were willing to accept the vaccine [24]. …”

“…Therefore, it is important to design and to implement interventions in order to increase the vaccination rate. The value observed in the present study is higher than those reported in other countries, since no women had received influenza vaccination in the already mentioned study in India [34], 3% in Turkey [36], 4% in Thailand [26], and it is almost identical to the 6% in Iran [37], 10.9% in Germany [38], and 16% in Canada [39]. Whereas, it is substantially below the levels observed in Australia with an uptake of 27% [20], in France of 39% [40], in Belgium of 42.8% [41], and in the United States with levels ranging from 35% [14] to 66.4% [42].…”

“…Several studies have investigated the level of knowledge and the attitudes among pregnant women about seasonal influenza and its vaccination [17–26] and this is extremely important in order to develop strategies to improve vaccination rates. Indeed, women with higher knowledge regarding the usefulness of the vaccination are more willing to receive the vaccine during pregnancy [27–29] and the uptake is influenced by the low perception of the risks related to influenza [17, 20, 30, 31].…”

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

“…Physicians were more likely to recommend influenza vaccine routinely when they had more than three years of practice, had treated pregnant women for influenza, perceived influenza vaccine to be effective and were aware of Ministry of Public Health’s (MOPH) recommendation of influenza vaccination in pregnancy. Understanding factors associated with Thai physicians’ decisions to recommend influenza vaccine to pregnant women is critical because physician recommendation of influenza vaccine is a key factor in Thai pregnant women’s decision to get vaccinated during pregnancy [15]. …”

“…Provider recommendation has been found to be one of the most effective motivators of vaccination among pregnant women [13,14], a phenomenon which is also seen amongst Thai pregnant women [15]. Surveys in the United States have found significant support for influenza vaccination in pregnancy among obstetricians [16, 17] as well as a high rate of routine recommendations for influenza vaccination by providers [18].…”