Maintaining the momentum: key factors influencing acceptance of influenza vaccination among pregnant women following the H1N1 pandemic

Beth A Halperin, Donna MacKinnon-Cameron, Shelly McNeil, Jennifer Kalil, Scott A Halperin, Beth A Halperin, Donna MacKinnon-Cameron, Shelly McNeil, Jennifer Kalil, Scott A Halperin

Abstract

This survey study compared pre- and post-pandemic knowledge, attitudes, beliefs, and intended behaviors of pregnant women regarding influenza vaccination (seasonal and/or pandemic) during pregnancy in order to determine key factors influencing their decision to adhere to influenza vaccine recommendations. Only 36% of 662 pre-pandemic respondents knew that influenza was more severe in pregnant women, compared to 62% of the 159 post-pandemic respondents. Of the pre-pandemic respondents, 41% agreed or strongly agreed that that it was safer to wait until after the first 3 months to receive the seasonal influenza vaccine, whereas 23% of the post-pandemic cohort agreed or strongly agreed; 32% of pre-pandemic participants compared to 11% of post-pandemic respondents felt it was best to avoid all vaccines while pregnant. Despite 61% of the pre-pandemic cohort stating that they would have the vaccine while pregnant if their doctor recommended it and 54% citing their doctor/nurse as their primary source of vaccine information, only 20% said their doctor discussed influenza vaccination during their pregnancy, compared to 77% of the post-pandemic respondents who reported having this conversation. Women whose doctors discussed influenza vaccine during pregnancy had higher overall knowledge scores (P<0.0001; P=0.005) and were more likely to believe the vaccine is safe in all stages of pregnancy (P<0.0001; P=0.001) than those whose doctors did not discuss influenza vaccination. The 2009 H1N1 pandemic experience appeared to change attitudes and behaviours of health care providers and their pregnant patients toward influenza vaccination.

Keywords: H1N1 pandemic; attitudes and behaviors; influenza vaccine; pregnancy; survey.

Figures

Figure 1.
Figure 1.
Proportion of respondents correctly answering knowledge-based questions. Black bars are pre-pandemic and white bars post-pandemic; error bars represent the 95% confidence intervals.

References

    1. CDC Prevention and control of influenza with vaccines: Recommendations of the advisory committee on immunization practices (ACIP). MMWR Recomm Rep 2010;59 (8):1-62.
    1. McNeil S, Halperin B, MacDonald N. Influenza in pregnancy: the case for prevention. Adv Exp Med Biol. 2009; 634:161-83; PMID:19280858; .
    1. McNeil SA, Dodds LA, Fell DB, Allen VM,Halperin BA, Steinhoff MC, MacDonald NE. Effect of respiratory hospitalization during pregnancy on infant outcomes. Am J Obstet Gynecol 2011; 204(6 Suppl 1):S54-7; PMID:21640231; .
    1. National Advisory Committee on Immunization Statement on influenza vaccination for 2013-2014. Can Commun Dis Rep 2013; 39(ACS-4):1-37.
    1. Schanzer D, Langley JM, Tam TWS. Influenza attributed hospitalization rates among pregnant women, Canada. J Obstet Gynaecol Can 2007; 29:622-9; PMID:17714614.
    1. Tamma PD, Ault KA, del Rio C, Steinhoff MC, Halsey NA, Omer SB. Safety of influenza vaccination during pregnancy. Am J Obstet Gynecol 2009; 201(6):547-52; PMID:19850275; .
    1. MacDonald NE, Riley LE. Steinhoff MC. Influenza immunization in pregnancy. Obstet Gynecol 2009; 114(2 Pt1):365-8; PMID:19622998; .
    1. Mak TK, Mangtani P, Leese J, Watson JM, Pfeifer D. Influenza vaccination in pregnancy: current evidence and selected national policies. Lancet Infect Dis 2008; 8:44-52; PMID:18156088; .
    1. World Health Organization . Vaccines against influenza: WHO position paper –November 2012. Wkly Epidemiol Rec 2012; 87:461-76; PMID:23210147.
    1. Jamieson DJ, Honein MA, Rasmussen SA, Williams JL, Swerdlow DL, Biggerstaff MS, Lindstrom S, Louie JK, Christ CM, Bohm SR, et al. . H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 2009; 374:451-8; PMID:19643469.
    1. Lapinsky SE. H1N1 novel influenza A in pregnant and immunocompromised patients. Crit Care Med 2010; 38(4 Suppl):e52-7; PMID:19935415; .
    1. Campbell A, Rodin R, Kropp R, Mao Y, Hong Z, Vachon J, Spika J, Pelletier L. Risk of severe outcomes among patients admitted to hospital with pandemic (H1N1) influenza. CMAJ 2010; 182(4): 349-55; PMID:20159893; .
    1. National Advisory Committee on Immunization Statement on seasonal trivalent inactivated influenza vaccine (TIV) for 2010-2011. Can Commun Dis Rep 2010; 36(ACS-6):1-49.
    1. Callaghan W, Chu S, Jamieson D. Deaths from seasonal influenza among pregnant women in the United States, 1998-2005. Obstet Gynecol 2010; 115:919-23; PMID:20410763;
    1. Fisher BM, Scott J, Hart J, Winn V, Gibbs R, Lynch AM. Behaviours and perceptions regarding seasonal and H1N1 influenza vaccination during pregnancy. Am J Obstet Gynecol 2011; 204(6 Suppl 107):S107-11; PMID:21419386; .
    1. Dodds L, McNeil SA, Fwell D, Allen VM, Coombs A, Scott J, MacDonald N. Impact of influenza exposure on rates of hospital admissions and physician visits because of respiratory illnesses among pregnant women. CMAJ 2007; 176(4):463-8; PMID:17296958; .
    1. CDC . Seasonal influenza and 2009 H1N1 influenza vaccination coverage among pregnant women – 10 states, 2009-10 influenza season. Morb Mortal Wkly Rep 2010; 59:1541-5; PMID:21124293.
    1. CDC . Influenza vaccination coverage among pregnant women – United States; 2010-11 influenza season. Morb Mortal Wkly Rep 2011; 60(32):1078-82; PMID:21849964.
    1. Henninger M, Crane B, Naleway A. Trends in influenza vaccine coverage in pregnant women, 2008 to 2012. Perm J 2013; 17(2):31-6; PMID:23704840; .
    1. Gorman JR, Brewer NT, Wang JB, Chambers CD. Theory-based predictors of influenza vaccination among pregnant women. Vaccine 2012; 31:213-8; PMID:23123019; .
    1. Public Health Agency of Canada. Flu-Watch Reports 2012-2013 season; /12-13/index-eng.php. Accessed August 11, 2014.
    1. Strang R, English P. Nova Scotia's response to H1N1: Summary report. Department of Health and Wellness. December 2010; . Accessed August 11, 2014.
    1. Ding H, Santibanez TA, Jamieson DJ, Weinbaum CM, Euler GL, Grohskopf LA, Lu PJ, Singleton JA. Influenza vaccination coverage among pregnant women – National 2009 H1N1 flu survey (NHFS). Am J Obstet Gynecol 2011; 204(6) (Suppl) S96-S106; PMID:21640233; .
    1. Gilmour H, Hofmann N. H1N1 vaccination. Health Rep 2010; 21(4):63-9; PMID:21269013.
    1. Eppes C, Wu A, You W, Cameron KA, Garcia P, Grobman W. Barriers to influenza vaccination among pregnant women. Vaccine 2013; 31:2874-8; PMID:23623863; .
    1. Schindler M, Blanchard-Rohner G, Meier S, Martinez de Tejada B, Siegrist CA, Burton-Jeangros C. Vaccination against seasonal flu in Switzerland: The indecision of pregnant women encouraged by healthcare professionals. Rev Epidemiol Sante Publique 2012; 60:447-53; PMID:23141298.
    1. Lynch MM, Mitchell EW, Williams JL, Brumbaugh K, Jones-Bell M, Pinkney DE, Layton CM, Mersereau PW, Kendrick JS, Medina PE, et al. . Pregnant and recently pregnant women's perceptions about Influenza A Pandemic (H1N1) 2009: Implications for public health and provider communication. Matern Child Health J 2012; 16:1657-64; PMID:21822963; .
    1. Meharry PM, Colson ER, Grizas AP, Stiller R, Vazquez M. Reasons why women accept or reject the trivalent inactivated influenza vaccine (TIV) during pregnancy. Matern Child Health J 2013; 17:156-64; PMID:22367067; .
    1. Naleway AL, Smith WJ, Mullooly JP. Delivering influenza vaccine to pregnant women. Epidemiol Rev 2006; 28:47-53; PMID:16731574; .

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner