Theory-based predictors of influenza vaccination among pregnant women

Moores UCSD Cancer Center and Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States.
Vaccine (Impact Factor: 3.62). 10/2012; 31(1). DOI: 10.1016/j.vaccine.2012.10.064
Source: PubMed


Guidelines recommend influenza vaccination for pregnant women, but vaccine uptake in this population is far below the goal set by Healthy People 2020. The purpose of this study was to examine predictors of seasonal influenza vaccination among pregnant women.

Between 2009 and 2012, the Vaccines and Medications in Pregnancy Surveillance System (VAMPSS) conducted a prospective cohort study of influenza vaccine safety among pregnant women in the US and Canada that oversampled vaccinated women. Data for the present paper are from an additional cross-sectional telephone survey completed during the 2010-2011 influenza season. We examined predictors of influenza vaccination, focusing on Health Belief Model (HBM) constructs.

We surveyed 199 pregnant women, 81% of whom had received a seasonal influenza vaccine. Vaccination was more common among women who felt more susceptible to influenza (OR=1.82, 95% CI 1.10-3.01), who perceived greater vaccine effectiveness (OR=3.92, 95% CI 1.48-10.43), and whose doctors recommended they have flu shots (OR=3.06, 95% CI 1.27-7.38). Those who perceived greater barriers of influenza vaccination had lower odds of vaccination (OR=0.19, 95% CI 0.05-0.75). Perceived social norms, anticipated inaction regret, and worry also predicted uptake, though demographic characteristics of respondents did not.

The HBM provides a valuable framework for exploring influenza vaccination among pregnant women. Our results suggest several potential areas of intervention to improve vaccination rates.

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    • "Our results agree with the findings of previous studies, including the quantitative arm of the present study. The role of health care professional advice, perceived susceptibility to disease, and social norms surrounding health care practice have all previously been identified as factors associated with vaccination in pregnancy (Fabry, Gagneur, & Pasquier, 2011; Gorman et al., 2012; Lau et al., 2010; Naleway et al., 2006). In the quantitative arm of this study, we found that pregnant women who had received a recommendation to have an influenza vaccine were 20 times more likely to receive the vaccine than those who received no such recommendation; women who had received a recommendation to have the pertussis vaccine postpartum were 7 times more likely to report intention to have the vaccine (Wiley, Massey, Cooper, Wood, Ho, et al., 2013; Wiley, Massey, Cooper, Wood, Quinn, & Leask, 2013). "
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