Abstract
BACKGROUND: Improving influenza and tetanus, diphtheria and acellular pertussis (Tdap) vaccine coverage among pregnant women is needed. PURPOSE: To assess factors associated with intention to receive influenza and/or Tdap vaccinations during pregnancy with a focus on perceptions of influenza and pertussis disease severity and influenza vaccine safety. METHODS: Participants were 325 pregnant women in Georgia recruited from December 2012 – April 2013 who had not yet received a 2012/2013 influenza vaccine or a Tdap vaccine while pregnant. Women completed a survey assessing influenza vaccination history, likelihood of receiving antenatal influenza and/or Tdap vaccines, and knowledge, attitudes and beliefs about influenza, pertussis, and their associated vaccines. RESULTS: Seventy-three percent and 81% of women believed influenza and pertussis, respectively, would be serious during pregnancy while 87% and 92% believed influenza and pertussis, respectively, would be serious to their infants. Perception of pertussis severity for their infant was strongly associated with an intention to receive a Tdap vaccine before delivery (p=0.004). Despite perceptions of disease severity for themselves and their infants, only 34% and 44% intended to receive antenatal influenza and Tdap vaccines, respectively. Forty-six percent had low perceptions of safety regarding the influenza vaccine during pregnancy, and compared to women who perceived the influenza vaccine as safe, women who perceived the vaccine as unsafe were less likely to intend to receive antenatal influenza (48% vs. 20%; p < 0.001) or Tdap (53% vs. 33%; p < 0.001) vaccinations. CONCLUSIONS: Results from this baseline survey suggest that while pregnant women who remain unvaccinated against influenza within the first three months of the putative influenza season may be aware of the risks influenza and pertussis pose to themselves and their infants, many remain reluctant to receive influenza and Tdap vaccines antenatally. To improve vaccine uptake in the obstetric setting, our findings support development of evidence-based vaccine promotion interventions which emphasize vaccine safety during pregnancy and mention disease severity in infancy.
Highlights
Respiratory infections like influenza and pertussis during pregnancy can pose serious risks to mother and infant.[1,2,3,4,5,6,7,8] Pregnant women are at increased risk of complications from influenza, and infants are not recommended to receive an influenza vaccine until 6 months of age.[9]
Perception of pertussis severity for their infant was strongly associated with an intention to receive a Tdap vaccine before delivery (p=0.004)
Antenatal influenza vaccination recommendations have been in place since the 1960’s16, and in the U.S, the Centers for Disease Control and Prevention (CDC) began recommending tetanus, diphtheria, and acellular pertussis (Tdap) vaccination during pregnancy, preferably in the third or late second trimester, in 2011.17 Based on previous research among pregnant women and healthy adults, both vaccines are considered safe during pregnancy.[18,19,20,21,22,23,24]
Summary
Respiratory infections like influenza and pertussis during pregnancy can pose serious risks to mother and infant.[1,2,3,4,5,6,7,8] Pregnant women are at increased risk of complications from influenza, and infants are not recommended to receive an influenza vaccine until 6 months of age.[9]. Antenatal influenza vaccination recommendations have been in place since the 1960’s16 , and in the U.S, the Centers for Disease Control and Prevention (CDC) began recommending tetanus, diphtheria, and acellular pertussis (Tdap) vaccination during pregnancy, preferably in the third or late second trimester, in 2011.17 Based on previous research among pregnant women and healthy adults, both vaccines are considered safe during pregnancy.[18,19,20,21,22,23,24] Despite CDC recommendations, coverage estimates for both vaccines remain suboptimal in the U.S The influenza vaccine coverage rate estimated by CDC among pregnant women is the U.S for the 2012 – 2013 season was 50.5%, and while coverage rates for antenatal Tdap vaccination are not yet available, estimates range between 2.6% – 10% (CDC, unpublished data, 2012). PURPOSE: To assess factors associated with intention to receive influenza and/or Tdap vaccinations during pregnancy with a focus on perceptions of influenza and pertussis disease severity and influenza vaccine safety
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