Does obstetrician knowledge regarding influenza increase HINI vaccine acceptance among their pregnant patients?
ABSTRACT 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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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.The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 02/2013; 26(12). DOI:10.3109/14767058.2013.775419 · 1.21 Impact Factor
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ABSTRACT: If distributed equitably, Human Papillomavirus (HPV) vaccines have the potential to reduce racial disparities in HPV-related diseases and cervical cancers. However, current trends in the US indicate low uptake among all adolescents, with persistent disparities among minority and low-income adolescents despite largely positive views of vaccination among their parents. As Black, Hispanic, and Asian populations continue to grow in the US over the next 40 y, it is imperative that we not only improve HPV vaccination rates overall, but focus on high-risk populations to prevent an increase in cervical cancer disparities. This review discusses initiation and completion rates of the three-dose HPV vaccine series among adolescents in high-risk groups and describes cultural similarities and differences in motivation and barriers to vaccination. The goal of this review is to highlight factors leading to vaccination in different adolescent racial groups and to help guide the development of strategies to increase rates of vaccine initiation and completion among groups at the highest risk for developing cervical cancer.Human Vaccines & Immunotherapeutics 04/2013; 9(7). DOI:10.4161/hv.24422 · 3.64 Impact Factor
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ABSTRACT: Pregnant women infected with influenza virus are more likely to experience severe complications when compared with their non-pregnant peers. Yet influenza vaccine uptake is low among pregnant women. The purpose of this study was to assess the prevalence of seasonal influenza vaccine uptake among pregnant women in Hong Kong and to identify predictors of vaccine uptake. Using a multi-center cross-sectional design, we recruited 2822 new mothers during their immediate postpartum stay from all eight public obstetric hospitals in Hong Kong. We assessed antenatal maternal influenza vaccination status as well as health beliefs and perceptions toward influenza and influenza vaccination. Bivariable and multivariable logistic regression was used to identify the predictors of vaccination uptake. Only 49 (1.7%; 95% CI 1.3-2.3%) participants were vaccinated during their pregnancy. Fear that the vaccine would cause harm to the fetus or themselves were the most common reasons for not being vaccinated. Being aware of the vaccination recommendations (OR=2.69; 95% CI 1.06, 6.82), being advised by a health-care provider (OR=6.30; 95% CI 3.19, 12.46), history of vaccination (OR=2.47; 95% CI 1.25, 4.91), perceived susceptibility to influenza infection (OR=3.67; 95% CI 1.64, 8.22), and perceived benefits of influenza vaccination (OR=9.98; 95% CI 3.79, 26.24) were all independently associated with vaccination. Perceived barriers to vaccination (OR=0.17; 95% CI 0.07, 0.40) were strongly associated with failure to vaccinate. Low seasonal influenza vaccination uptake among Hong Kong pregnant women was related to a number of factors, all of which are amenable to interventions. Vaccination promotion strategies need to focus on encouraging health-care providers to discuss vaccination with their pregnant clients and in providing pregnant women with accurate and unbiased information about the risks of influenza infection and the benefits of vaccination.Vaccine 09/2013; 31(45). DOI:10.1016/j.vaccine.2013.08.063 · 3.49 Impact Factor