More Work to Do in Encouraging Flu Vaccination During Pregnancy

SAN DIEGO — A number of factors influence whether a medical professional will get vaccinated against influenza during pregnancy, according to survey results presented here at the 55th Annual ICAAC/ICC 2015 Meeting. 

Michael Desjardins, PhD, an infectious disease fellow based in Montreal, Quebec, and colleagues administered an online survey to healthcare providers involved in pregnancy care, in Quebec, between Jan. 15 and Feb. 15 of this year.¹ 

Three hundred and forty-four participants answered the survey, including 134 general practitioners, 91 obstetrician-gynecologists, 76 midwives, and 43 nurse practitioners. 

Desjardins and colleagues noted that 60% of the healthcare professionals offered influenza vaccine to pregnant women in adherence with guidelines in Quebec. 

Adherence rates were widely influenced by the type of clinician responding to the survey, with 80% of ob-gyns adhering to influenza guidelines, compared with 72% for nurse practitioners, 67% for general practitioners and 12% for midwives. The researchers noted a lower number of pregnancies, working in a non-academic practice and a reported age of younger than 40 were all associated with lower adherence to influenza vaccination guidelines.

The researchers noted that although the study was not designed to explore reasons for non-adherence to vaccination guidelines, they noted that “some participants, especially midwives, commented on the fact that issues of accessibility to free vaccines in clinics and the need to refer patients to an outside vaccination clinic may limit abilities and motivation to vaccinate patients.” 

The researchers urged education about the “benefits associated with influenza vaccine and its safety during pregnancy.” 

In an interview with Infectious Disease Advisor, Dr Desjardins explained that there are several misconceptions that often lead to women avoiding obtaining their influenza vaccine, including the belief that the vaccine will harm the baby.

“We have a lot of studies that show that the influenza vaccine in pregnancy is effective and reduces morbidity and mortality in both the mother and the baby,” Dr Desjardins said. “We just have to get that word out to the public.” 

The data from Canada mirror data from the United States, published today by the Centers for Disease Control and Prevention, that show that there is more work to do in vaccinating all pregnant women who are eligible to be vaccinated.² 

That data indicate that “during the 2014–15 influenza season approximately half of surveyed pregnant women had received influenza vaccination, similar to the percentages found for the 2013–14 (52.2%), 2012–13 (50.5%), and 2011–12 (46.4%) influenza seasons.”

In that study, the researchers noted that: “A substantially higher percentage of women who reported that their provider both recommended and offered influenza vaccination had received influenza vaccine compared with women who reported receiving only a recommendation but no offer or no recommendation; however, the percentage of women receiving a provider offer and recommendation was similar to last season.”

The CDC data also indicated concerns about safety as a potential barrier to pregnant women getting vaccinated, as well as “lack of confidence in vaccine efficacy.” 

Reference

1. Desjardins M. “Influenza Vaccine in Pregnancy: Low Compliance Rate Among Healthcare Providers.” Presented at: ICAAC/ICC 2015; Sept. 17-21, 2015; San Diego. 
2. CDC. Influenza Vaccination Coverage Among Pregnant Women — United States, 2014–15 Influenza Season. MMWR. 2015; 64(36);1000-1005.