Uptake of influenza vaccine by pregnant women: A cross-sectional survey

862957 .
The Medical journal of Australia (Impact Factor: 4.09). 04/2013; 198(7):373-5. DOI: 10.5694/mja12.11849
Source: PubMed


To determine influenza vaccination coverage among pregnant women in New South Wales, and factors associated with vaccine uptake during pregnancy.
Quantitative self-administered survey of pregnant women, using a non-random, stratified sample from antenatal clinics at three demographically diverse hospitals in NSW during the influenza season of 2011.
Self-reported influenza vaccine uptake while pregnant; and attitudes, barriers and facilitators to vaccine acceptance during pregnancy.
Of 939 women approached, 815 participated (87%). Influenza vaccine uptake in pregnant women was 27%. Women who had received a recommendation to have the vaccine were 20.0 times (95% CI, 10.9-36.9) more likely to have been vaccinated. Forty-two per cent recalled receiving a recommendation to be vaccinated. Other factors associated with vaccination were study site, perceived infection severity, overall feelings toward vaccination during pregnancy, vaccine accessibility, and willingness to take up the vaccine if recommended. Concern about the baby's safety was negatively associated with vaccination (odds ratio, 0.5; 95% CI, 0.2-0.9), but 68% (95% CI, 63%-71%) of women who expressed concern agreed they would have the vaccine if their health care professional recommended it.
Recommendation from a health care provider is strongly associated with influenza vaccine uptake among pregnant women and can overcome their concerns about safety, but less than half the women surveyed reported receiving such a recommendation. Educational material targeting pregnant women and professional education and support for antenatal health care providers are needed to increase awareness and recommendation.

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Available from: Peter Massey
    • "Finally, twenty-five of the remaining 1565 articles Addional reco rds id enfi ed throug h oth er sources (n = 0) Records idenfied through databas e searchin g (n = 2, were retrieved based on their title and abstract content. After full review, we excluded 14 papers because they included an ineligible population (n = 5) or outcome (n = 4), did not have a standard care group for comparison (n = 4), or were a review article (n = 1)4445464748495051525354555657 (see Supplementary File). No additional articles were identified from the reference lists of the relevant publications and 11 studies that met the selection criteria were reviewed. "
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    ABSTRACT: Background: Pregnant women and their infants under 6 months of age infected with influenza have a high risk of serious morbidity and mortality. Influenza vaccine during pregnancy offers 3-for-1 benefits to pregnant women, fetuses and newborn infants. Current vaccination uptake rates during pregnancy, however, are often lower than other high-risk groups and the general population. Methods: We systematically reviewed evidence on the effectiveness of interventions to improve influenza vaccination coverage in pregnant women. Risk differences (RDs) were calculated from the included studies. Results: Eleven studies were included in the review, of which four were randomized controlled trials (RCTs). Three cohort studies assessed provider-focused interventions while four RCTs and one cohort study evaluated pregnant women-focused interventions. Two cohort studies and a prospective intervention study assessed the effectiveness of bundled interventions. No study solely assessed the effectiveness of interventions to enhance access to influenza vaccination. One moderate quality RCT showed that an influenza pamphlet, with or without a verbalized benefit statement, improved the vaccination rate (RD=0.26; RD=0.39). The other reviewed RCTs showed discordant results, with RDs ranging from -0.15 to 0.03. Although all observational studies significantly improved vaccination rates (RDs ranged from 0.03 to 0.44), the quality of the evidence varied. Conclusions: There is a lack of effective interventions to increase the influenza vaccination rate in pregnant women. Based on the existing research, we recommend that clinicians provide influenza pamphlets to pregnant women with a verbalized statement about the benefits of influenza vaccine to newborns. Further high-quality RCTs are needed to develop successful maternal influenza vaccination programs. Increased clarity in reporting the content of interventions would help to improve the comparability and generalizability of the published studies.
    No preview · Article · Nov 2015 · Vaccine
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    • "The results of this survey demonstrated a significant association between FP discussion about whooping cough booster vaccine recommendations and vaccine uptake. Several studies have demonstrated that a recommendation from a physician can improve vaccine uptake in both the adolescent and adult community [17] [18] [19]. Overall, however, the vast majority of respondents reported that their FP had not discussed pertussis booster vaccines, despite the study being conducted immediately following a global pertussis epidemic. "
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    ABSTRACT: Objective: Pertussis is a highly virulent vaccine preventable disease that remains a global challenge. This study aimed to assess community knowledge of pertussis infection as well as awareness and uptake of adult pertussis booster vaccine. Methods: A cross-sectional survey was conducted of randomly selected households in South Australia by Computer Assisted Telephone Interviews in 2011. Survey data were weighted to the age, gender and geographical area profile of the population. Results: From 3124 randomly sampled contactable households, 1967 interviews were conducted (participation rate 63%) with individuals aged 18-93 years, including 608 parents of children aged <18 years. The majority of respondents (97%) had heard of pertussis (whooping cough) and 18% reported that a household member had previously contracted whooping cough infection. Most respondents considered whooping cough to be highly contagious (73%) and severe for infants (89%). Over half (51%) of those surveyed were aware that family members commonly transmit pertussis to infants. Despite high knowledge, pertussis vaccine uptake was low, with only 10% of respondents reporting pertussis vaccination in the previous five years. Whilst 61% of respondents were aware of the availability of an adult pertussis booster vaccine, only 8% (n=154) reported their Family Physician had discussed it with them. If provided free, 77% agreed that they would be more likely to accept a booster pertussis vaccination. Independent predictors of recent pertussis vaccination included higher education, larger household size, perception of greater disease severity for infants and discussion with a Family Physician about pertussis vaccination. Conclusions: Whilst knowledge regarding transmission and severity of Bordetella pertussis was high, uptake of pertussis vaccination for adults is remarkably low amongst the South Australian community. Improved awareness regarding the availability of a booster pertussis vaccine through Family Physicians and/or provision of funded pertussis vaccination for adults has the potential to improve pertussis vaccine coverage.
    Preview · Article · Oct 2015 · Vaccine
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    • "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). These results confirm our qualitative findings relating to the integral role of the health care provider in how pregnant women view and act on vaccination. "
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    ABSTRACT: Internationally, pregnant and postpartum women have been the focus of influenza and pertussis immunization campaigns, with differing levels of vaccine acceptance. We used semistructured interviews to explore pregnant women's perspectives on influenza vaccination during pregnancy and postpartum pertussis vaccination. Many women saw pregnancy as a busy time filled with advice on what they "should" and "should not" do to ensure the health of their fetus, and vaccinating themselves was regarded as just one of these tasks needing consideration. Women were more concerned about potential risks to their infants' health before their own. They saw influenza as a disease affecting the mother, whereas they viewed pertussis as a threat to the baby and therefore comparatively more risky. They were thus more likely to intend to vaccinate against pertussis to protect their infant. Framing of vaccination information toward protection of the baby might help increase vaccine uptake among pregnant women.
    Full-text · Article · Sep 2014 · Qualitative Health Research
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