Infect Chemother.  2009 Dec;41(6):349-354. 10.3947/ic.2009.41.6.349.

Influenza Vaccine Coverage Rate and Related Factors on Pregnant Women

• Kim MJ
• Lee SY
• Lee KS
• Kim A
• Son D
• Chung MH
• Park SG
• Park JH
• Lee BI
• Lee JS

• KMID: 2285040
• DOI: http://doi.org/10.3947/ic.2009.41.6.349

Abstract

BACKGROUND
During seasonal influenza epidemics and previous pandemics, pregnant women have been at increased risk for complications related to influenza infection. Although influenza vaccination has been widely recommended to pregnant women and immunocompromised hosts, the vaccination rate is presumed to be low in pregnant women. This study was aimed to evaluate the vaccination rate and factors associated with Influenza vaccination among pregnant women, who are at high risk for developing complications from the influenza. MATERIALS AND METHODS: This study was carried out by telephone survey from April, 2007 to August, 2007. Women who were in their second trimester of pregnancy or above,- during October, 2006 and February, 2007, the recommended vaccination period, and had given birth at Inha University Hospital were selected as the study population. Immunization status, general understanding, and factors associated with vaccination were evaluated. RESULTS: Among a total of 506 eligible pregnant women, 227 (44.8%) responded to the questionnaires. The influenza vaccination rate among the pregnant women was only 4% (9/227). Major reasons for not receiving vaccination were first, not awaring the necessity of immunization during pregnancy (48.5%, 110/227) and second, misunderstanding that it is prohibited during pregnancy (36.1%, 82/227). The major factors that influenced the compliance of vaccination were correct understanding and doctor's recommendation on the influenza immunization during pregnancy. CONCLUSIONS: The influenza vaccine coverage on pregnant women was very low and the awareness of influenza vaccination during pregnancy in general was inaccurate. Shift in perception is required and this can be achieved by educating the pregnant women on the safety and efficacy of vaccination. In addition, doctors' active encouragement to vaccination is highly recommended.

Keyword

Influenza vaccine; Immunization rate; Pregnant women; Vaccination

MeSH Terms

Compliance
Female
Humans
Immunization
Immunocompromised Host
Influenza Vaccines
Influenza, Human
Pandemics
Parturition
Pregnancy
Pregnancy Trimester, Second
Pregnant Women
Seasons
Telephone
Vaccination
Surveys and Questionnaires
Influenza Vaccines

Reference

1. Meier CR, Napalkov PN, Wegmüller Y, Jefferson T, Jick H. Population-based study on incidence, risk factors, clinical complications and drug utilisation associated with influenza in the United Kingdom. Eur J Clin Microbiol Infect Dis. 2000. 19:834–842.

2. Sprenger MJ, Mulder PG, Beyer WE, Van Strik R, Masurel N. Impact of influenza on mortality in relation to age and underlying disease, 1967-1989. Int J Epidemiol. 1993. 22:334–340.

3. Nichol KL, Lind A, Margolis KL, Murdoch M, McFadden R, Hauge M, Magnan S, Drake M. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med. 1995. 333:889–893.

4. ridges CB, Thompson WW, Meltzer MI, Reeve GR, Talamonti WJ, Cox NJ, Lilac HA, Hall H, Klimov A, Fukuda K. Effectiveness and cost-benefit of influenza vaccination of healthy working adults: a randomized controlled trial. JAMA. 2000. 284:1655–1663.

5. Jackson LA, Jackson ML, Nelson JC, Neuzil KM, Weiss NS. Evidence of bias in estimates of influenza vaccine effectiveness in seniors. Int J Epidemiol. 2006. 35:337–344.

6. Simonsen L, Taylor RJ, Viboud C, Miller MA, Jackson LA. Mortality benefits of influenza vaccination in elderly people: an ongoing controversy. Lancet Infect Dis. 2007. 7:658–666.

7. Harris JW. Influenza occurring in pregnant women: a statistical study of thirteen hundred and fifty cases. JAMA. 1919. 72:978–980.

8. Widelock D, Csizmas L, Klein S. Influenza, pregnancy, and fetal outcome. Public Health Rep. 1963. 78:1–11.

9. Freeman DW, Barno A. Deaths from Asian influenza associated with pregnancy. Am J Obstet Gynecol. 1959. 78:1172–1175.

10. Naleway AL, Smith WJ, Mullooly JP. Delivering influenza vaccine to pregnant women. Epidemiol Rev. 2006. 28:47–53.

11. Hardy JM, Azarowicz EN, Mannini A, Medearis DN Jr, Cooke RE. The effect of Asian influenza on the outcome of pregnancy, Baltimore, 1957-1958. Am J Public Health Nations Health. 1961. 51:1182–1188.

12. Rasmussen SA, Jamieson DJ, Bresee JS. Pandemic Influenza and Pregnant Women. Emerg Infect Dis. 2008. 14:95–100.

13. Kee SY, Lee JS, Cheong HJ, Chun BC, Song JY, Choi WS, Jo YM, Seo YB, Kim WJ. Influenza vaccine coverage rates and perceptions on vaccination in South Korea. J Infect. 2007. 55:273–281.

14. Lim WS, Macfarlane JT, Colthorpe CL. Treatment of community-acquired lower respiratory tract infections during pregnancy. Am J Respir Med. 2003. 2:221–233.

15. Mullooly JP, Barker WH, Nolan TF Jr. Risk of acute respiratory disease among pregnant women during influenza A epidemics. Public Health Rep. 1986. 101:205–211.

16. Dodds L, McNeil SA, Fell DB, Allen VM, Coombs A, Scott J, MacDonald N. Impact of influenza exposure on rates of hospital admissions and physician visits because of respiratory illness among pregnant women. CMAJ. 2007. 176:463–468.

17. Lu P, Bridges CB, Euler GL, Singleton JA. Influenza vaccination of recommended adult populations, U.S., 1989-2005. Vaccine. 2008. 26:1786–1793.

18. Holm MV, Blank PR, Szucs TD. Trends in influenza vaccination coverage rates in Germany over five seasons from 2001 to 2006. BMC Infect Dis. 2007. 7:144.

19. Zhou W, Pool V, Iskander JK, English-Bullard R, Ball R, Wise RP, Haber P, Pless RP, Mootrey G, Ellenberg SS, Braun MM, Chen RT. Surveillance for safety after immunization: Vaccine Adverse Event Reporting System (VAERS)--United States, 1991-2001. MMWR Surveill Summ. 2003. 52:1–24.

20. Lasky T, Terracciano GJ, Magder L, Koski CL, Ballesteros M, Nash D, Clark S, Haber P, Stolley PD, Schonberger LB, Chen RT. The Guillain-Barré syndrome and the 1992-1993 and 1993-1994 influenza vaccines. New Engl J Med. 1998. 339:1797–1802.

21. Munoz FM, Greisinger AJ, Wehmanen OA, Mouzoon ME, Hoyle JC, Smith FA, Glezen WP. Safety of influenza vaccination during pregnancy. Am J Obstet Gynecol. 2005. 192:1098–1106.

22. Sumaya CV, Gibbs RS. Immunization of pregnant women with influenza A/New Jersey/76 virus vaccine: reactogenicity and immunogenicity in mother and infant. J Infect Dis. 1979. 140:141–146.

23. Englund JA, Mbawuike IN, Hammill H, Holleman MC, Baxter BD, Glezen WP. Maternal immunization with influenza or tetanus toxoid vaccine for passive antibody protection in young infants. J Infect Dis. 1993. 168:647–656.

24. Puck JM, Glezen WP, Frank AL, Six HR. Protection of infants from infection with influenza A virus by transplacentally acquired antibody. J Infect Dis. 1980. 142:844–849.

25. Lanternier F, Henegar C, Mouthon L, Blanche P, Guillevin L, Launay O. Low influenza-vaccination rate among adults receiving immunosuppressive therapy for systemic inflammatory disease. Ann Rheum Dis. 2008. 67:1047.

26. Zimmerman RK, Nowalk MP, Bardella IJ, Fine MJ, Janosky JE, Santibanez TA, Wilson SA, Raymund M. Physician and practice factors related to influenza vaccination among the elderly. Am J Prev Med. 2004. 26:1–10.

27. Nichol KL, Mac Donald R, Hauge M. Factors associated with influenza and pneumococcal vaccination behavior among high-risk adults. J Gen Intern Med. 1996. 11:673–677.