Pregnant and Recently Pregnant Women’s Perceptions about Influenza A Pandemic (H1N1) 2009: Implications for Public Health and Provider Communication

Abstract

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.

Improving rates of maternal immunization: Challenges and opportunities

“…47,50 The desire to protect the fetus/infant and oneself from disease was a strong predictor of immunization. 22,23,29,34,42,46,55,56 Most consistently, having the vaccine recommended AND offered by their healthcare provider [21][22][23]25,28,29,[31][32][33][34][37][38][39][40]42,45,46,50,[54][55][56][57][58][59][60] and trusting the recommendations 47 were identified most frequently as important in increasing vaccine uptake. For influenza vaccine, prior vaccination of oneself 25,28,34,45,46,53,60 or one's partner 59 in previous years was a strong predictor of acceptance of vaccination during pregnancy.…”

“…22,25,32,34,35 Protect baby and self from disease. 22,23,29,34,42,46,55,56 Text messaging with general pregnancy health and vaccination information, and appointment reminders. 81,82 Lack of vaccine knowledge.…”

Comparison of text-messaging to voice telephone interviews for active surveillance of adverse events following immunisation

“…Misperceptions of vaccine safety are a common contributor to low immunisation rates [2][3][4][5][6]. 60…”

Maintaining the momentum: Key factors influencing acceptance of influenza vaccination among pregnant women following the H1N1 pandemic

“…Similar to other pandemic research, our survey found that witnessing the pandemic had a definite impact on seasonal and pandemic influenza vaccine coverage. Lynch et al 27 describe the impact of appraised threat to a pregnant women's perceptions of their vulnerability to, and the severity of, H1N1 and their subsequent preventive behavior. In our study, women in the postpandemic group stated they were more likely to get the seasonal vaccine after witnessing the pandemic, citing both their own safety and safety of their family as reasons.…”