Acceptance of seasonal influenza vaccination and associated factors among pregnant women in the context of COVID-19 pandemic in China: a multi-center cross-sectional study based on health belief model

Na Han,Fenglan Sun,Ruitong Wang,Liqun Chi,Jue Liu,Lixia Deng,Chuanxiang Yuan,Min Liu,Jihong Liu,Liyuan Tao,Chunhua Han

doi:10.1186/s12884-021-04224-3

Abstract

BackgroundSeasonal influenza can circulate in parallel with coronavirus disease (COVID-19) in winter. In the context of COVID-19 pandemic, the risk of co-infection and the burden it poses on healthcare system calls for timely influenza vaccination among pregnant women, who are the priority population recommended for vaccination. We aimed to evaluate the acceptance of influenza vaccination and associated factors among pregnant women during COVID-19 pandemic, provide evidence to improve influenza vaccination among pregnant women, help reduce the risk of infection and alleviate the burden of healthcare system for co-infected patients.MethodsWe conducted a multi-center cross-sectional study among pregnant women in China. Sociodemographic characteristics, health status, knowledge on influenza, attitude towards vaccination, and health beliefs were collected. Locally weighted scatterplot smoothing regression analysis was used to evaluate the trends in the acceptance of influenza vaccine. Logistic regression was applied to identify factors associated with vaccination acceptance.ResultsThe total acceptance rate was 76.5% (95%CI: 74.8–78.1%) among 2568 pregnant women enrolled. Only 8.3% of the participants had a history of seasonal influenza vaccination. In the logistic regression model, factors associated with the acceptance of influenza vaccine were western region, history of influenza vaccination, high knowledge of influenza infection and vaccination, high level of perceived susceptibility, perceived benefit, cues to action and low level of perceived barriers. Among 23.5% of the participants who had vaccine hesitancy, 48.0% of them were worried about side effect, 35.6% of them lacked confidence of vaccine safety.ConclusionsOur findings highlighted that tailored strategies and publicity for influenza vaccination in the context of COVID-19 pandemic are warranted to reduce pregnant women’s concerns, improve their knowledge, expand vaccine uptake and alleviate pressure for healthcare system.

Highlights

Seasonal influenza can circulate in parallel with coronavirus disease (COVID-19) in winter
Our findings highlighted that tailored strategies and publicity for influenza vaccination in the context of COVID-19 pandemic are warranted to reduce pregnant women’s concerns, improve their knowledge, expand vaccine uptake and alleviate pressure for healthcare system
We conducted a multi-center hospital-based cross-sectional study in mainland China based on the Health Belief Model, in order to have a better understanding of the acceptance, knowledge and barriers of influenza vaccination among pregnant women, provide evidence for healthcare workers and policy makers to identify potential barriers and take tailored measures to expand influenza vaccination coverage during the COVID-19 pandemic period

Summary

Introduction

Seasonal influenza can circulate in parallel with coronavirus disease (COVID-19) in winter. In the context of COVID-19 pandemic, the risk of co-infection and the burden it poses on healthcare system calls for timely influenza vaccination among pregnant women, who are the priority population recommended for vaccination. Influenza infection usually peaks in winter seasons [4], circulating in parallel with COVID-19, which could pose burden on the prevention and treatment of both diseases. Despite increasing recommendations to vaccinate pregnant women in many countries, influenza vaccination coverage around the world remained suboptimal. According to national surveys in multiple European countries, the median influenza vaccine coverage rate among pregnant women was merely 9% from 2008/2009 to 2014/2015 [11], indicating that more attention and publicity should be given from related organizations to raise pregnant women’s awareness of their vulnerability to seasonal influenza and the significance of influenza vaccination, while understanding the causes of their vaccine hesitancy

Objectives

Methods

Results

Discussion

Conclusion