Abstract
BackgroundPregnant women have an increased risk of influenza complications. Influenza vaccination during pregnancy is safe and effective, however coverage in Australia is less than 40%. Pregnant women who receive a recommendation for influenza vaccination from a health care provider are more likely to receive it, however the perspectives of Australian general practitioners has not previously been reported. The aim of the study was to investigate the knowledge, attitudes, beliefs, and practices of general practitioners practicing in South-Western Sydney, Australia towards influenza vaccination during pregnancy.MethodsA qualitative descriptive study was conducted, with semi-structured interviews completed with seventeen general practitioners in October 2012. A thematic analysis was undertaken by four researchers, and transcripts were analysed using N-Vivo software according to agreed codes.ResultsOne-third of the general practitioners interviewed did not consider influenza during pregnancy to be a serious risk for the mother or the baby. The majority of the general practitioners were aware of the government recommendations for influenza vaccination during pregnancy, but few general practitioners were confident of their knowledge about the vaccine and most felt they needed more information. More than half the general practitioners had significant concerns about the safety of influenza vaccination during pregnancy. Their practices in the provision of the vaccine were related to their perception of risk of influenza during pregnancy and their confidence about the safety of the vaccine. While two-thirds reported that they are recommending influenza vaccination to their pregnant patients, many were adopting principles of patient-informed choice in their approach and encouraged women to decide for themselves whether they would receive the vaccine.ConclusionsGeneral practitioners have varied knowledge, attitudes, and beliefs about influenza vaccination during pregnancy, which influence their practices. Addressing these could have a significant impact on improving vaccine uptake during pregnancy.
Highlights
Pregnant women have an increased risk of influenza complications
Other general practitioners said that they were aware that the risks are reported to be higher in pregnant women compared to the general population, they had no direct experience of a pregnant patient contracting influenza and having serious consequences, and that this in turn decreased their perception of the risk
Many of the general practitioners interviewed in this study demonstrated limited knowledge about the risks of influenza infection and vaccination during pregnancy, or expressed limited confidence in the safety of the vaccine
Summary
Pregnant women have an increased risk of influenza complications. Influenza vaccination during pregnancy is safe and effective, coverage in Australia is less than 40%. Pre-natal influenza infection is associated with an increased risk for both mother and baby, including respiratory and cardio-pulmonary hospitalisation, pre-term delivery, fetal distress, and in some cases death [1,2,3,4,5,6,7]. These risks are compounded when the mother has comorbidities such as asthma or diabetes, or is infected with a pandemic strain of the virus [4,8]. The proportion of pregnant women who receive the vaccine is low, with coverage between 10 and 40% [19,20,21,22,23]
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