Abstract
BackgroundPhysician recommendation and attitudes and beliefs of pregnant women toward influenza and vaccination may influence vaccine uptake during pregnancy. We examined how physician recommendation and health beliefs of pregnant women may jointly affect influenza vaccination during pregnancy.MethodsThai pregnant women aged ≥18 years and >13 gestational weeks attending antenatal care (ANC) clinics, and ANC physicians were recruited during May‐August 2015. Women and physicians, linked using unique identifiers, provided data on demographic, health and work history, knowledge, attitudes, and beliefs toward influenza and vaccination, based on Health Belief Model constructs. Physicians also provided data on their practices in recommending influenza vaccination during pregnancy. Prevalence ratios for the association between knowledge, attitudes and beliefs of pregnant women, physician recommendation and documented receipt of vaccination within 30 days of the visit were calculated.ResultsAmong 610 women, the median age was 27 years; 266 (44%) and 344 (56%) were in the second and third trimesters, respectively. Twenty‐one (3%) had pre‐existing conditions. Of 60 physicians with the median years of practice of 5; 17 (28%) reported frequently/usually/always recommending influenza vaccine to their pregnant patients, while 43 (72%) reported never/rarely/sometimes recommending the vaccine. Controlling for the pregnant women's knowledge and beliefs, pregnant women whose physician recommended influenza vaccination were 2.3 times (95% confidence interval 1.4‐3.8) more likely to get vaccinated.ConclusionsIn this study, physician recommendation was the only significant factor associated with influenza vaccine uptake among Thai pregnant women. Understanding physicians’ motivation/barrier to recommending influenza vaccination to pregnant women may increase coverage.
Highlights
Physician recommendation and attitudes and beliefs of pregnant women toward influenza and vaccination may influence vaccine uptake during pregnancy
The efforts within Rajavithi Hospital to increase influenza vaccine uptake apparently increased the proportion of pregnant women vaccinated, the vaccination rate among participating pregnant women was low
Physician recommendation was the most important factor associated with influenza vaccine uptake among Thai pregnant women and the women's perceptions about vaccination had no important association with being vaccinated
Summary
Pregnant women are at increased risk of hospitalization due to influenza compared with both the general population and women of childbearing age,[1,2] there is inconsistent and limited evidence that influenza virus infection causes adverse pregnancy outcomes.[3]. The safety of influenza vaccination during pregnancy was determined through post‐licensure vaccine safety monitoring platforms: pregnancy exposure registries; active and passive surveillance systems; and observational studies.[17] These platforms have demonstrated the safety of influenza vaccine administration during pregnancy to the mother, fetus, and newborn[18,19] and few non‐medically and medically attended adverse events.[20-22]. Few studies have simultaneously evaluated physicians’ and pregnant woman's attitudes and beliefs about influenza vaccination during pregnancy to determine the impact of the interaction between physicians and vaccine recipients on vaccination uptake.[37,38]. We examined how these two perspectives may affect influenza vaccination during pregnancy Few studies have simultaneously evaluated physicians’ and pregnant woman's attitudes and beliefs about influenza vaccination during pregnancy to determine the impact of the interaction between physicians and vaccine recipients on vaccination uptake.[37,38] We examined how these two perspectives may affect influenza vaccination during pregnancy
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