Influenza Vaccination Rates in Pregnancy Fall Short of ACIP Target

Data from the Birth Defects Study found that influenza vaccination coverage rose during the 2012–2013 and 2013–2014 season from 35% to 41%, respectively. 

Pregnant women and infants are at a higher risk for influenza-associated complications. Receiving influenza vaccination during pregnancy has been shown to protect infants for several months after birth. The Advisory Committee on Immunization Practices (ACIP) updated their guidelines in 2004 to recommend that “women who will be pregnant during the influenza season” receive the seasonal influenza vaccine no matter which trimester she is in.

The latest study data from the Centers for Disease Control and Prevention (CDC) reported overall coverage of 50% in influenza vaccination among pregnant women (2015–2016 influenza season) with an estimated 14% being vaccinated ≤5–6 months pre-pregnancy and 36% being vaccinated during pregnancy.

In addition, researchers at the Birth Defects Study of the Slone Epidemiology Center at Boston University tracked vaccinations received during pregnancy since the 2005–2006 influenza vaccination season. They reported on trends in seasonal influenza vaccination coverage among pregnant women in the Birth Defects Study during 2005–2014 as well as the settings in which the women were vaccinated.

In the seasons prior to the 2009–2010 pandemic H1N1 influenza season, the vaccination coverage was approximately 20% among mothers of infants without major structural birth defects (control newborns). Infants with major structural birth defects (cases) were identified at study centers that included participating hospitals as well as birth defects registries in some states. Within 6 months post-delivery, mothers of case and control infants were able to participate in a computer-assisted telephone interview. 

During the 2009–2010 season, seasonal influenza vaccination coverage among pregnant women rose to 33% and to 35% for the pH1N1 vaccine. The next two influenza vaccination seasons (2010–2011 and 2011–2012) saw a slight decline to 31% and 27%, respectively. Since then, coverage increased again to 35% in the 2012–2013 season and to 41% during the 2013–2014 season. 

The majority of flu vaccinations (79%) during the 2013–2014 season for pregnant women occurred in a traditional healthcare setting such as the obstetrician’s office, primary care physician’s office, or a prenatal clinic. The proportion of vaccine doses received in pharmacy/supermarket settings increased from 4% in 2005–2006 to 8% in 2013–2014, and the proportion received at work or school decreased from 23% in 2006–2007 to 10% in 2013–2014.

Although the increasing trend is encouraging, “coverage still falls far short of the 2016 ACIP recommendation that all pregnant women who are or might become pregnant during flu season be vaccinated.” The CDC reported that during the 2015–2016 season, 63% of pregnant women whose provider recommended and offered the vaccination received it vs 38% who received a recommendation but not offered the vaccine. Increasing vaccination rates among women who are pregnant or may become pregnant during the influenza season is a core public health and clinical practice goal, the report concluded.

Reference

Kerr S, Van Bennekom CM, Mitchell AA. Influenza vaccination coverage during pregnancy—selected sites, United States, 2005-06 through 2013-14 influenza vaccine seasons. MMWR Morbid Mortal Wkly Rep. 2016;65:1370-1373. doi: 10.15585/mmwr.mm6548a3

This article originally appeared on MPR