Connect
MJA
MJA

Uptake of influenza vaccine by pregnant women: a cross-sectional survey

Kerrie E Wiley, Peter D Massey, Spring C Cooper, Nicholas J Wood, Jane Ho, Helen E Quinn and Julie Leask
Med J Aust 2013; 198 (7): 373-375. || doi: 10.5694/mja12.11849

Summary

Objectives: To determine influenza vaccination coverage among pregnant women in New South Wales, and factors associated with vaccine uptake during pregnancy.

Design, setting and participants: Quantitative self-administered survey of pregnant women, using a non-random, stratified sample from antenatal clinics at three demographically diverse hospitals in NSW during the influenza season of 2011.

Main outcome measures: Self-reported influenza vaccine uptake while pregnant; and attitudes, barriers and facilitators to vaccine acceptance during pregnancy.

Results: Of 939 women approached, 815 participated (87%). Influenza vaccine uptake in pregnant women was 27%. Women who had received a recommendation to have the vaccine were 20.0 times (95% CI, 10.9–36.9) more likely to have been vaccinated. Forty-two per cent recalled receiving a recommendation to be vaccinated. Other factors associated with vaccination were study site, perceived infection severity, overall feelings toward vaccination during pregnancy, vaccine accessibility, and willingness to take up the vaccine if recommended. Concern about the baby’s safety was negatively associated with vaccination (odds ratio, 0.5; 95% CI, 0.2–0.9), but 68% (95% CI, 63%–71%) of women who expressed concern agreed they would have the vaccine if their health care professional recommended it.

Conclusion: Recommendation from a health care provider is strongly associated with influenza vaccine uptake among pregnant women and can overcome their concerns about safety, but less than half the women surveyed reported receiving such a recommendation. Educational material targeting pregnant women and professional education and support for antenatal health care providers are needed to increase awareness and recommendation.

  • Kerrie E Wiley1,2
  • Peter D Massey3
  • Spring C Cooper4
  • Nicholas J Wood2
  • Jane Ho1
  • Helen E Quinn1
  • Julie Leask5

  • 1 National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Sydney, NSW.
  • 2 Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW.
  • 3 Population Health, Hunter New England Population Health, Tamworth, NSW.
  • 4 Western Sydney Sexual Health Centre, University of Sydney, Sydney, NSW.
  • 5 School of Public Health, University of Sydney, Sydney, NSW.


Acknowledgements: 

We acknowledge A Raeburn and P Cashman of Hunter New England Area Population Health; C King of the National Centre for Immunisation Research and Surveillance; L Taylor and J Bentley of the Centre for Epidemiology and Evidence, NSW Ministry of Health; and the staff of Westmead Hospital Antenatal Clinic, Royal Prince Alfred Women and Babies, and Tamworth Rural Referral Hospital Antenatal Clinic. This study was funded by the Financial Markets Foundation for Children (grant 2010-099).

Competing interests:

Julie Leask participated in an Australian Research Council Linkage grant on paediatric influenza vaccination that received partial funding from Sanofi Pasteur.

  • 1. Neuzil KM, Reed GW, Mitchel EF, et al. Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women. Am J Epidemiol 1998; 148: 1094-1102.
  • 2. ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System. Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study. BMJ 2010; 340: c1279.
  • 3. Jamieson DJ, Honein MA, Rasmussen SA, et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 2009; 374: 451-458.
  • 4. Tamma PD, Steinhoff MC, Omer SB. Influenza infection and vaccination in pregnant women. Expert Rev Respir Med 2010; 4: 321-328.
  • 5. Eick AA, Uyeki TM, Klimov A, et al. Maternal influenza vaccination and effect on influenza virus infection in young infants. Arch Pediatr Adolesc Med 2011; 165: 104-111.
  • 6. Zaman K, Roy E, Arifeen SE, et al. Effectiveness of maternal influenza immunization in mothers and infants. N Engl J Med 2008; 359: 1555-1564.
  • 7. National Health and Medical Research Council. Australian immunisation handbook. 9th ed. Canberra: NHMRC, 2008.
  • 8. Lu AB, Halim AA, Dendle C, et al. Influenza vaccination uptake amongst pregnant women and maternal care providers is suboptimal. Vaccine 2012; 30: 4055-4059.
  • 9. Mak DB, Daly AM, Armstrong PK, Effler PV. Pandemic (H1N1) 2009 influenza vaccination coverage in Western Australia. Med J Aust 2010; 193: 401-404. <MJA full text>
  • 10. McCarthy EA, Pollock WE, Nolan T, et al. Improving influenza vaccination coverage in pregnancy in Melbourne 2010-2011. Aust N Z J Obstet Gynaecol 2012; 52: 334-341.
  • 11. White SW, Petersen RW, Quinlivan JA. Pandemic (H1N1) 2009 influenza vaccine uptake in pregnant women entering the 2010 influenza season in Western Australia. Med J Aust 2010; 193: 405-407. <MJA full text>
  • 12. Armitage CJ, Conner M. Social cognition models and health behaviour: a structured review. Psychol Health 2000; 15: 173-189.
  • 13. Li Z, McNally L, Hilder L, Sullivan EA. Australia’s mothers and babies 2009. (AIHW Cat. No. PER 52; Perinatal Statistics Series No. 25.) Sydney: Australian Institute of Health and Welfare, 2011.
  • 14. MacDonald R, Baken L, Nelson A, Nichol KL. Validation of self-report of influenza and pneumococcal vaccination status in elderly outpatients. Am J Prev Med 1999; 16: 173-177.
  • 15. Mangtani P, Shah A, Roberts JA. Validation of influenza and pneumococcal vaccine status in adults based on self-report. Epidemiol Infect 2007; 135: 139-143.
  • 16. Centers for Disease Control and Prevention. Influenza vaccination coverage among pregnant women: 2011-12 influenza season, United States. MMWR Morb Mortal Wkly Rep 2012; 61: 758-763.
  • 17. Naleway AL, Smith WJ, Mullooly JP. Delivering influenza vaccine to pregnant women. Epidemiol Rev 2006; 28: 47-53.
  • 18. Tong A, Biringer A, Ofner-Agostini M, et al. A cross-sectional study of maternity care providers’ and women’s knowledge, attitudes, and behaviours towards influenza vaccination during pregnancy. J Obstet Gynaecol Can 2008; 30: 404-410.
  • 19. Wu P, Griffin MR, Richardson A, et al. Influenza vaccination during pregnancy: opinions and practices of obstetricians in an urban community. South Med J 2006; 99: 823-828.
  • 20. Broughton DE, Beigi RH, Switzer GE, et al. Obstetric health care workers’ attitudes and beliefs regarding influenza vaccination in pregnancy. Obstet Gynecol 2009; 114: 981-987.
  • 21. Wallis DH, Chin JL, Sur DK. Influenza vaccination in pregnancy: current practices in a suburban community. J Am Board Fam Pract 2004; 17: 287-291.
  • 22. Lee T, Saskin R, McArthur M, McGeer A. Beliefs and practices of Ontario midwives about influenza immunization. Vaccine 2005; 23: 1574-1578.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.