Abstract
BackgroundAlthough the World Health Organization and health authorities in most countries recommend that pregnant women receive inactivated influenza virus vaccines, coverage remains low. This study aimed to investigate (1) the proportion of pregnant women who received an influenza vaccination and influencing factors and (2) the proportion of obstetrics and gynecology (OBGYN) doctors who routinely recommend influenza vaccination to pregnant women and influencing factors.MethodsTwo separate, anonymized questionnaires were developed for physicians and pregnant and postpartum women and were distributed to multicenters and clinics in South Korea. The proportions of women who received influenza vaccination during pregnancy and OBGYN doctors who routinely recommend the influenza vaccine to pregnant women were analyzed. Independent influencing factors for both maternal influenza vaccination and OBGYN doctors’ routine recommendations to pregnant women were analyzed using log-binomial regression analysis.ResultsThe proportion of self-reported influenza vaccination during pregnancy among 522 women was 63.2%. Pregnancy-related independent factors influencing maternal influenza vaccination were “(ever) received information about influenza vaccination during pregnancy” (OR 8.9, 95% CI 4.17–19.01), “received vaccine information about from OBGYN doctors” (OR 11.44, 95% CI 5.46–24.00), “information obtained from other sources” (OR 4.38, 95% CI 2.01–9.55), and “second/third trimester” (OR 2.41, 95% CI 1.21–4.82)..Among 372 OBGYN doctors, 76.9% routinely recommended vaccination for pregnant women. Independent factors effecting routine recommendation were “working at a private clinic or hospital” (OR 5.33, 95% CI 2.44–11.65), “awareness of KCDC guidelines” (OR 3.11, 95% CI 1.11–8.73), and “awareness of the 2019 national free influenza vaccination program for pregnant women” (OR 4.88, 95% CI 2.34–10.17). OBGYN doctors most commonly chose ‘guidelines proposed by the government or public health (108, 46%) and academic committees (59, 25%), as a factor which expect to affect the future recommendationConclusionThis study showed that providing information about maternal influenza vaccination, especially by OBGYN doctors, is crucial for increasing vaccination coverage in pregnant women. Closer cooperation between the government and OBGYN academic societies to educate OBGYN doctors might enhance routine recommendations.
Highlights
The World Health Organization and health authorities in most countries recommend that pregnant women receive inactivated influenza virus vaccines, coverage remains low
This study showed that providing information about maternal influenza vaccination, especially by obstetrics and gynecology (OBGYN) doctors, is crucial for increasing vaccination coverage in pregnant women
In multivariate analyses adjusted for maternal age, education, occupation, location of residence, and pregnancy period, “ever received information about influenza vaccination during pregnancy”, “received vaccine information about from OBGYN doctors”, “information obtained from other sources”, and “second/third trimester” significantly increased the odds for influenza vaccination
Summary
The World Health Organization and health authorities in most countries recommend that pregnant women receive inactivated influenza virus vaccines, coverage remains low. During the 2009 H1N1 influenza pandemic season, maternal influenza infection was associated with severe complications resulting in maternal death and admission to intensive care units [3]. Infants younger than six months cannot be protected except through maternal immunization. Approximately 228,000 (95% Confidence Interval (CI) 150,000–344,000) of annual hospitalizations of infants younger than six months were associated with influenza [4]. Infants younger than six months with confirmed influenza infection were at highest risk for hospitalization due to neurologic or pulmonary complications and, for admission to an intensive care unit [5, 6]. Several studies have demonstrated the effectiveness of maternal influenza vaccination for protecting infants younger than six months from influenza, respiratory infection, and severe pneumonia [7, 8]
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