Determinants of influenza vaccination uptake in pregnancy: a large single-Centre cohort study

Stéphanie Bartolo,Karine Faure,Sophie Carpentier,Yamina Hammou,Ophélie Mancel,Philippe Dufour,Damien Subtil,Sophie Vanderstichele,Emilie Deliege,Marielle Roumilhac,Rodrigue Dessein

doi:10.1186/s12884-019-2628-5

Abstract

BackgroundAlthough vaccination of pregnant women against influenza is recommended, the vaccination rate remains low. We conducted a study to identify determinants of influenza vaccination uptake in pregnancy in order to identify strategies to improve seasonal influenza vaccination rates.MethodsProspective observational hospital-based study in the French hospital performing the highest number of deliveries, located in the city of Lille, among all women who had given birth during the 2014–2015 influenza season. Data were collected through a self-completed questionnaire and from medical files. The vaccination uptake was self-reported. Determinants of vaccination uptake were identified using logistic regression analysis.ResultsOf the 2045 women included in the study, 35.5% reported that they had been vaccinated against influenza during their pregnancy. The principal factors significantly associated with greater vaccination uptake were previous influenza vaccination (50.9% vs 20.2%, OR 4.1, 95% CI 3.1–5.5), nulliparity (41.0% vs 31.3%, OR 2.5, 95% CI 1.7–3.7), history of preterm delivery < 34 weeks (43.4% vs 30.3%, OR 2.3, 95% CI 1.1–4.9), the mother’s perception that the frequency of vaccine complications for babies is very low (54.6% vs 20.6%, OR 1.1, 95% CI 0.5–2.2), the mother’s good knowledge of influenza and its vaccine (61.7% vs 24.4%, OR 3.1, 95% CI 2.2–4.4), hospital-based prenatal care in their first trimester of pregnancy (55.0% vs 30.2%, OR 2.1, 95% CI 1.2–3.7), vaccination recommendations during pregnancy by a healthcare worker (47.0% vs 2.7%, OR 18.8, 95% CI 10.0–35.8), receipt of a vaccine reimbursement form (52.4% vs 18.6%, OR 2.0, 95% CI 1.5–2.7), and information from at least one healthcare worker about the vaccine (43.8% vs 19.1%, OR 1.8, 95% CI 1.3–2.6).ConclusionsOur findings suggest that in order to increase flu vaccination compliance among pregnant women, future public health programmes must ensure cost-free access to vaccination, and incorporate education about the risks of influenza and the efficacy/safety of vaccination and clear recommendations from healthcare professionals into routine antenatal care.

Highlights

IntroductionSeasonal influenza vaccination during pregnancy reduces the risk of an influenza diagnosis by 50% [3]
Seasonal influenza is a common and contagious illness with an annual attack rate estimated at 5–10% in adults [1], pregnant women being at increased risks of morbidity and death [1], even those with no comorbidities [2].Seasonal influenza vaccination during pregnancy reduces the risk of an influenza diagnosis by 50% [3]
Our study examined the potential determinants of the influenza vaccination uptake amongst pregnant women in a single centre in France

Summary

Introduction

Seasonal influenza vaccination during pregnancy reduces the risk of an influenza diagnosis by 50% [3]. It confers effective protection up to the age of 6 months for newborns whose mother was vaccinated during pregnancy [4] with a reduction of 63% in influenza cases and of 29% in episodes of febrile respiratory illness [5]. We investigated a large number of possible determinants, in order to find strategies to improve seasonal influenza vaccination rate. Vaccination of pregnant women against influenza is recommended, the vaccination rate remains low. We conducted a study to identify determinants of influenza vaccination uptake in pregnancy in order to identify strategies to improve seasonal influenza vaccination rates

Methods

Results

Discussion

Conclusion