Does obstetrician knowledge regarding influenza increase HINI vaccine acceptance among their pregnant patients?

Northwestern University, Feinberg School of Medicine, United States.
Vaccine (Impact Factor: 3.62). 06/2012; 30(39):5782-4. DOI: 10.1016/j.vaccine.2012.06.032
Source: PubMed


Although numerous studies have demonstrated the safety and benefits of influenza vaccination in pregnancy, vaccination rates of pregnant women have remained low. The objective of this study is to evaluate whether physicians' level of knowledge regarding H1N1 influenza in pregnancy is associated with vaccination frequency among their patients.
Between October 2009 and May 2010, all obstetricians (attending and resident physicians) at an urban tertiary care hospital were asked to complete a test that assessed knowledge of influenza. During this same time period, the vaccination status of all inpatient parturients was recorded. Associations between physician characteristics, physician test scores, and patient vaccination rates were assessed.
110 providers (85% of those eligible) belonging to 16 practices completed the knowledge assessment. The mean (±SD) test score was 72% (±11%). Provider test scores were not associated with whether the provider was a trainee, the number of years since completion of training, or provider age. Test scores were not correlated with the number of providers or number of deliveries per month in a given practice. Mean scores were significantly higher (75% vs 68%, p=004) among those who attended a hospital-sponsored educational forum on H1N1, and were positively and significantly associated with the percentage of patients cared for by that group who were vaccinated against H1N1 influenza (r=.50, p=.045).
Increased physician knowledge regarding H1N1 influenza, represented as higher test scores on a knowledge assessment test, was significantly associated with the frequency of H1N1 vaccination among their patients.

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    • "Our research findings concur with the results of previous studies which report that other antenatal care providers have varying levels of knowledge about influenza vaccination during pregnancy [22,28-30,36]. This is significant, as increased levels of provider knowledge are associated with higher rates of influenza vaccination in pregnant patients [28]. "
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    ABSTRACT: Background Pregnant women have an increased risk of influenza complications. Influenza vaccination during pregnancy is safe and effective, however coverage in Australia is less than 40%. Pregnant women who receive a recommendation for influenza vaccination from a health care provider are more likely to receive it, however the perspectives of Australian general practitioners has not previously been reported. The aim of the study was to investigate the knowledge, attitudes, beliefs, and practices of general practitioners practicing in South-Western Sydney, Australia towards influenza vaccination during pregnancy. Methods A qualitative descriptive study was conducted, with semi-structured interviews completed with seventeen general practitioners in October 2012. A thematic analysis was undertaken by four researchers, and transcripts were analysed using N-Vivo software according to agreed codes. Results One-third of the general practitioners interviewed did not consider influenza during pregnancy to be a serious risk for the mother or the baby. The majority of the general practitioners were aware of the government recommendations for influenza vaccination during pregnancy, but few general practitioners were confident of their knowledge about the vaccine and most felt they needed more information. More than half the general practitioners had significant concerns about the safety of influenza vaccination during pregnancy. Their practices in the provision of the vaccine were related to their perception of risk of influenza during pregnancy and their confidence about the safety of the vaccine. While two-thirds reported that they are recommending influenza vaccination to their pregnant patients, many were adopting principles of patient-informed choice in their approach and encouraged women to decide for themselves whether they would receive the vaccine. Conclusions General practitioners have varied knowledge, attitudes, and beliefs about influenza vaccination during pregnancy, which influence their practices. Addressing these could have a significant impact on improving vaccine uptake during pregnancy.
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    ABSTRACT: Abstract Objective: To describe the characteristics of pregnant women who accept the influenza vaccine and evaluate the relationship between vaccination and adverse pregnancy outcomes. Methods: Retrospective cohort study of women receiving prenatal care during the 2009-2011 influenza seasons. Vaccination status was ascertained through our perinatal record system and clinic vaccination logs. Pregnancy outcomes included a primary composite of miscarriage, fetal demise, preterm birth (PTB) <37 weeks and neonatal demise. Stratification and logistic regression were used to adjust for potential confounders. Results: Of 3,104 eligible pregnant women, 1,094 (35%) received the influenza vaccine. Women vaccinated were more likely to be older, obese, primiparae, and have medical complications or a prior PTB. In univariable analyses, flu vaccination was associated with increased adverse composite outcome and PTB. After multivariable adjustments, vaccination was no longer associated with adverse outcomes in women with medical complications but remained associated with adverse outcomes among those without known co-morbidity. Conclusions: Vaccination was associated with increased adverse composite outcome in pregnant women without identified co-morbidity but not those with co-morbidities. This association is likely due to selection bias, which should be considered in planning of observational studies of the impact of vaccination on pregnancy outcomes.
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    Human Vaccines & Immunotherapeutics 04/2013; 9(7). DOI:10.4161/hv.24422 · 2.37 Impact Factor
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