To estimate patients' perceptions of the need, safety and acceptability of vaccination during pregnancy.
An office-based survey was offered to patients presenting for obstetric and gynecologic care from December 2007 to July 2008 at an academic women's hospital. The anonymous questionnaire assessed demographics, medical and vaccination history, interest in receiving vaccines, and beliefs about vaccination safety. Data were evaluated using descriptive statistics and chi2 analyses.
A total of 1,436 completed surveys were available for analysis, including 573 from pregnant women. Pregnant women were less likely than non-pregnant women to report perceived risks from vaccine-preventable illness (22.8% vs. 34.5%, p < 0.001) and to believe that their doctor thinks they should get vaccines (42.6% vs. 49.7%, p < 0.027). Nearly two-thirds (61%) reported concern about possible vaccine effects on their pregnancy. However, the overwhelming majority (89%) of pregnant women surveyed reported willingness to accept vaccination during pregnancy if recommended by their obstetrician.
Despite concerns about vaccine safety and a low perceived need for immunization, most pregnant respondents endorse acceptance of vaccination when recommended by their obstetrician. These findings suggest that obstetric providers should maximize opportunities for uptake of appropriate immunizations during pregnancy.
[Show abstract][Hide abstract] ABSTRACT: Influenza exposure during pregnancy can cause severe health problems for both the mother and her offspring, including an increased risk of mortality. Influenza vaccination during all trimesters of pregnancy is safe and effective, and recommended by professional organizations such as the American College of Obstetrics and Gynecology. Despite these recommendations, the U.S. vaccination rates remain low in this high-risk population.
A policy analysis based on the five-part method identified by Teitelbaum and Wilensky () addresses factors to consider in identifying the best voluntary policy options to improve the vaccination rates. The authors provide discussion of the background, landscape, and stakeholder interests and the pros and cons of two voluntary policy options to increase vaccination. The policy options include: (a) financial incentives for providers and (b) an education emphasis for providers and staff.
The authors conclude that based on considerations of cost, provider preference, and practicality of implementation, a continuing educational intervention is the preferred policy venue to increase vaccination rates.
Public Health Nursing 01/2014; 31(3). DOI:10.1111/phn.12099 · 0.83 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Group B Streptococcus (GBS) causes significant infant morbidity and mortality. Promising GBS vaccines are currently in clinical trials. Because GBS vaccines would be the first to specifically target pregnant women, we sought to assess acceptability of a hypothetical GBS vaccine.
We performed an internet survey among currently pregnant or recently delivered women receiving care at one of 9Ob/Gyn practices in Colorado. Vaccine acceptability was assessed using questions based on constructs from the Health Belief Model. Multivariable analyses assessed the characteristics associated with GBS vaccine acceptability during the current/recent pregnancy.
The response rate was 50% (n=231). While 78% agreed that a GBS vaccine would be a good way to protect newborns, 90% and 83% agreed, respectively, that they worried generally about the safety and effectiveness of new vaccines. Moreover, 39% believed it is generally dangerous for pregnant women to get vaccines. Seventy nine percent 'definitely' or 'probably' would have gotten a GBS vaccine in their most recent pregnancy if available. The most influential factors associated with this outcome were a strong belief in the vaccine's benefits (adjusted odds ratio [AOR] 6.37, 95% confidence interval [CI] 2.01-20.16), and low perceived barriers to vaccination (AOR 0.11, 95% CI (0.03-0.37)).
A GBS vaccine may be acceptable to pregnant women but would benefit from strong provider support and education about the risks and consequences of GBS infection and the benefits to vaccination.
[Show abstract][Hide abstract] ABSTRACT: Maternal immunization holds tremendous promise to improve maternal and neonatal health for a number of infectious conditions. The unique susceptibilities of pregnant women to infectious conditions, as well as the ability of maternally-derived antibody to offer vital neonatal protection (via placental transfer), together have produced the recent increased attention on maternal immunization. The Advisory Committee on Immunization Practices (ACIP) currently recommends 2 immunizations for all pregnant women lacking contraindication, inactivated Influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap). Given ongoing research the number of vaccines recommended during pregnancy is likely to increase. Thus, achieving high vaccination coverage of pregnant women for all recommended immunizations is a key public health enterprise. This review will focus on the present state of vaccine acceptance in pregnancy, with attention to currently identified barriers and determinants of vaccine acceptance. Additionally, opportunities for improvement will be considered.
Human Vaccines and Immunotherapeutics 06/2014; 10(9):1-9. DOI:10.4161/21645515.2014.970901 · 2.37 Impact Factor
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