tetano
Editor, Senior Moderator
Women are at increased risk for morbidity and mortality from influenza during pregnancy (1). Vaccinating pregnant women for influenza can protect both the women and their infants, especially infants aged <6 months who are not old enough to receive influenza vaccination (2--4). Since 2004, the Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists have recommended inactivated influenza vaccine for all women who are pregnant during influenza season, regardless of trimester (1,5). Before 2009, estimated influenza vaccination coverage among pregnant women had been consistently low (approximately 15%) (1,5). However, vaccination levels increased substantially in response to the 2009 influenza A (H1N1) pandemic to nearly 50% (6--7). To estimate influenza vaccination coverage among pregnant women for the 2010--11 season, CDC analyzed data from an Internet panel survey conducted in April 2011 among women who were pregnant any time during October 2010--January 2011. Among 1,457 survey respondents, 49% reported that they had received influenza vaccination: 12% were vaccinated before pregnancy, 32% during pregnancy, and 5% after pregnancy. Women offered influenza vaccination by a health-care provider (62%) were more likely to be vaccinated (71%) than other women (14%) and were more likely to have positive attitudes about vaccine effectiveness and safety. These results indicate that the higher vaccination level achieved the previous season (2009--10) was sustained and emphasize the critical role of health-care providers in promoting influenza vaccination. Continued efforts are needed to encourage health-care providers to strongly recommend and offer influenza vaccination to pregnant patients to protect both the mothers and their infants.
CDC conducted an Internet panel survey during April 4--25, 2011, to provide end-of-season estimates of influenza vaccination coverage and information on knowledge, attitudes, and behaviors related to influenza vaccination among pregnant women. Women aged 18--49 years who were pregnant at any time since August 1, 2010, were recruited from the SurveySpot panel operated by Survey Sampling International.* Of all panel members contacted in April 2011, a total of 2,126 were determined to be eligible for the survey, and 1,937 (91%) completed the online survey. The sample was weighted to reflect the age and race/ethnicity distribution based on census region estimates from the U.S. population of pregnant women (8). To be consistent with a previous study (6), the study population was limited to 1,457 women reporting pregnancy at any time during the peak influenza vaccination period (October 2010--January 2011).
Survey respondents were asked if they had an influenza vaccination since August 1, 2010, and if yes, in which month and whether it was before, during, or after pregnancy. Pregnancy status questions included whether respondents were currently pregnant or pregnant at any time since August 1, 2010, and if so, what were the actual months of pregnancy. Respondents who were pregnant at the time of the survey were asked their expected delivery date. All respondents were asked if their doctor or other health professional had offered them influenza vaccination during an office visit and their attitudes toward influenza and influenza vaccination. Weighted analyses were conducted using statistical software. Confidence intervals were calculated, and chi-square tests were used to assess statistical significance of differences in vaccination coverage levels between subgroups.
Of the 1,457 women pregnant at any time during October 2010--January 2011, 49% reported influenza vaccination for the 2010--11 season: 12% were vaccinated before pregnancy, 32% during pregnancy, and 5% after pregnancy. Vaccination after pregnancy was more prevalent for women delivering early in the vaccination period, and vaccination before pregnancy was more prevalent among women who were in earlier stages of pregnancy later in the vaccination period (Figure). Younger women (aged 18--24 years) were less likely to be vaccinated than older women (aged 25--49 years) (44% versus 52%) (Table 1). College graduates were more likely to be vaccinated than those with less education. Women with health insurance coverage also were more likely to report influenza vaccination compared with those who were not insured.
Overall, 62% of women reported that they were offered influenza vaccination by their health-care providers; among those offered vaccination, 71% received influenza vaccination, substantially higher than the 14% vaccination level among women whose health-care providers did not offer vaccination (Table 1). Forty-five percent of women reported influenza vaccination in a previous influenza season, and these women were four times as likely to report 2010--11 vaccination as women without previous vaccination (84% versus 21%).
Compared with women whose health-care provider did not offer vaccination, women who received a health-care provider offer were more likely to have positive attitudes about the effectiveness of influenza vaccination (82% versus 54%), safety of influenza vaccination for pregnant women (78% versus 53%), and safety of vaccination for their infants (75% versus 47%) (Table 2). In addition, women who received a health-care provider offer consistently had higher vaccination levels than those who did not receive a health-care provider offer, regardless of their perceptions of vaccination safety or effectiveness expressed in April 2011. Moreover, women with a negative attitude toward vaccination who had received a health-care provider offer of vaccination were more likely to be vaccinated than women who had a positive attitude without a health-care provider offer.
The top five "main" reasons for not receiving influenza vaccination were "I am concerned about possible safety risks to my baby if I got vaccinated" (20%), "I am concerned that the vaccination would give me the flu" (17%), "I don't think the vaccination is effective in preventing flu" (14%), "I am concerned about possible safety risk to myself if I got vaccinated" (11%), and either "I don't think I would get very sick if I got the flu" or "I think if I get the flu, I will just get some medication to treat it" (14%).
The majority of women who were vaccinated during pregnancy received vaccination at their obstetrician/gynecologist or midwife's office (61%), followed by another doctor's office or another medical-related place (22%), a pharmacy or grocery store (8%), health department (5%), and their workplace or school (5%). Among women vaccinated either before or after pregnancy, 18% were vaccinated in an obstetrician/gynecologist or midwife's office, and 61% in another doctor's office or another medical-related place.
Reported by
Deborah K Walker, EdD, Sarah Ball, ScD, Robert Black, MPH, David Izrael, MS, Abt Associates, Inc., Atlanta, Georgia. Helen Ding, MD, Gary L. Euler, DrPH, James A. Singleton, MS, Carolyn B. Bridges, MD, Immunization Svc Div, Lisa A. Grohskopf, MD, Influenza Div, National Center for Immunization and Respiratory Diseases; Denise J. Jamieson, MD, Div of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. Corresponding contributor: Helen Ding, hding@cdc.gov, 404-639-8513.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6032a2.htm?s_cid=mm6032a2_w
CDC conducted an Internet panel survey during April 4--25, 2011, to provide end-of-season estimates of influenza vaccination coverage and information on knowledge, attitudes, and behaviors related to influenza vaccination among pregnant women. Women aged 18--49 years who were pregnant at any time since August 1, 2010, were recruited from the SurveySpot panel operated by Survey Sampling International.* Of all panel members contacted in April 2011, a total of 2,126 were determined to be eligible for the survey, and 1,937 (91%) completed the online survey. The sample was weighted to reflect the age and race/ethnicity distribution based on census region estimates from the U.S. population of pregnant women (8). To be consistent with a previous study (6), the study population was limited to 1,457 women reporting pregnancy at any time during the peak influenza vaccination period (October 2010--January 2011).
Survey respondents were asked if they had an influenza vaccination since August 1, 2010, and if yes, in which month and whether it was before, during, or after pregnancy. Pregnancy status questions included whether respondents were currently pregnant or pregnant at any time since August 1, 2010, and if so, what were the actual months of pregnancy. Respondents who were pregnant at the time of the survey were asked their expected delivery date. All respondents were asked if their doctor or other health professional had offered them influenza vaccination during an office visit and their attitudes toward influenza and influenza vaccination. Weighted analyses were conducted using statistical software. Confidence intervals were calculated, and chi-square tests were used to assess statistical significance of differences in vaccination coverage levels between subgroups.
Of the 1,457 women pregnant at any time during October 2010--January 2011, 49% reported influenza vaccination for the 2010--11 season: 12% were vaccinated before pregnancy, 32% during pregnancy, and 5% after pregnancy. Vaccination after pregnancy was more prevalent for women delivering early in the vaccination period, and vaccination before pregnancy was more prevalent among women who were in earlier stages of pregnancy later in the vaccination period (Figure). Younger women (aged 18--24 years) were less likely to be vaccinated than older women (aged 25--49 years) (44% versus 52%) (Table 1). College graduates were more likely to be vaccinated than those with less education. Women with health insurance coverage also were more likely to report influenza vaccination compared with those who were not insured.
Overall, 62% of women reported that they were offered influenza vaccination by their health-care providers; among those offered vaccination, 71% received influenza vaccination, substantially higher than the 14% vaccination level among women whose health-care providers did not offer vaccination (Table 1). Forty-five percent of women reported influenza vaccination in a previous influenza season, and these women were four times as likely to report 2010--11 vaccination as women without previous vaccination (84% versus 21%).
Compared with women whose health-care provider did not offer vaccination, women who received a health-care provider offer were more likely to have positive attitudes about the effectiveness of influenza vaccination (82% versus 54%), safety of influenza vaccination for pregnant women (78% versus 53%), and safety of vaccination for their infants (75% versus 47%) (Table 2). In addition, women who received a health-care provider offer consistently had higher vaccination levels than those who did not receive a health-care provider offer, regardless of their perceptions of vaccination safety or effectiveness expressed in April 2011. Moreover, women with a negative attitude toward vaccination who had received a health-care provider offer of vaccination were more likely to be vaccinated than women who had a positive attitude without a health-care provider offer.
The top five "main" reasons for not receiving influenza vaccination were "I am concerned about possible safety risks to my baby if I got vaccinated" (20%), "I am concerned that the vaccination would give me the flu" (17%), "I don't think the vaccination is effective in preventing flu" (14%), "I am concerned about possible safety risk to myself if I got vaccinated" (11%), and either "I don't think I would get very sick if I got the flu" or "I think if I get the flu, I will just get some medication to treat it" (14%).
The majority of women who were vaccinated during pregnancy received vaccination at their obstetrician/gynecologist or midwife's office (61%), followed by another doctor's office or another medical-related place (22%), a pharmacy or grocery store (8%), health department (5%), and their workplace or school (5%). Among women vaccinated either before or after pregnancy, 18% were vaccinated in an obstetrician/gynecologist or midwife's office, and 61% in another doctor's office or another medical-related place.
Reported by
Deborah K Walker, EdD, Sarah Ball, ScD, Robert Black, MPH, David Izrael, MS, Abt Associates, Inc., Atlanta, Georgia. Helen Ding, MD, Gary L. Euler, DrPH, James A. Singleton, MS, Carolyn B. Bridges, MD, Immunization Svc Div, Lisa A. Grohskopf, MD, Influenza Div, National Center for Immunization and Respiratory Diseases; Denise J. Jamieson, MD, Div of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. Corresponding contributor: Helen Ding, hding@cdc.gov, 404-639-8513.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6032a2.htm?s_cid=mm6032a2_w