Women's HealthVaccination Against Influenza in Pregnancy: A Survey of Canadian Maternity Care Providers
Section snippets
INTRODUCTION
Pregnancy increases the risk of serious complications and hospitalization from seasonal influenza.1, 2, 3 Influenza vaccine administered during pregnancy is effective and can reduce influenza-like illness.4, 5, 6 It can additionally protect infants from influenza infection during their first months of life.6 In Canada, the National Advisory Committee on Immunization has recommended universal vaccination against influenza in pregnancy since 2007.1 However, influenza vaccine uptake in pregnancy
Data Collection
In Canada, no official list of maternity care providers is available. In July and August 2017, a Web-based survey was distributed using Survey Monkey to maternity care providers practicing in Canada. The survey was developed by an interdisciplinary group of maternity care providers and expert researchers and used the results of a previous qualitative study with maternity care providers.34 Data collection was led by the SOGC in partnership with several professional organizations across Canada,
Participants’ Characteristics
A total of 1542 participants completed the questionnaire, and 129 (8.4%) of these participants were excluded because they did not provide pregnancy care. An additional 278 participants were excluded from analysis because either they did not answer the sociodemographic section (n = 271) or did not complete any question (n = 7). Of the remaining 1135 participants, 1061 completed the items on influenza vaccine recommendations and were included in this analysis.
The characteristics of the
DISCUSSION
To the best of our knowledge, this study is the first that has investigated the opinions and behaviours associated with seasonal influenza vaccination during pregnancy in a large and diverse group of maternity care providers in Canada. In our study, almost three fourths of the surveyed maternity care providers reported having recommended influenza vaccine to all pregnant patients during the influenza season before the study. This finding is congruent with the results of other studies that have
CONCLUSION
Health care providers play an important role in social acceptance of vaccination in general and in pregnancy. Despite years of research and innovative interventions to increase maternal vaccination rates, rates of influenza vaccination in pregnant individuals are still alarmingly low (<30%) in Canada. Increasing the uptake of recommended vaccines in pregnancy is largely dependent on maternity care providers’ recommendations. Despite strong recommendations by North American medical and public
Acknowledgements
This study received funds from the Canadian Immunization Research Network and from the Public Health Agency of Canada. Dr. Dubé is supported by a Fonds de recherche du Québec - Santé (FRQS) Research Scholar Junior 1 award. Dr. Witteman is supported by an FRQS Research Scholar Junior 2 award. Dr. Bettinger is supported by a Career Investigator Award from the Michael Smith Foundation for Health Research. Dr. Greyson is supported by a Trainee Award from the Michael Smith Foundation for Health
REFERENCES (47)
- et al.
H1N1 2009 influenza virus infection during pregnancy in the USA
Lancet
(2009) - et al.
Acceptability and feasibility of seasonal influenza vaccine administration in an antenatal clinic setting
J Obstet Gynaecol Can
(2010) - et al.
Understanding factors influencing vaccination acceptance during pregnancy globally: a literature review
Vaccine
(2015) - et al.
Protecting newborns from pertussis: the role of partner vaccination in the era of maternal immunization
Eur J Obstet Gynecol Reprod Biol
(2017) - et al.
Pregnant women's intention to take up a post-partum pertussis vaccine, and their willingness to take up the vaccine while pregnant: a cross sectional survey
Vaccine
(2013) - et al.
Experiences and perspectives of mothers of the pertussis vaccination programme in London
Public Health
(2017) - et al.
Determinants of uptake of influenza vaccination among pregnant women - a systematic review
Vaccine
(2014) - et al.
Does obstetrician knowledge regarding influenza increase HINI vaccine acceptance among their pregnant patients?
Vaccine
(2012) - 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) - et al.
Maternal pertussis and influenza immunization coverage and attitude of health care workers towards these recommendations in Flanders, Belgium
Vaccine
(2016)
Influenza vaccination attitudes and practices among US registered nurses
Am J Infect Control
Influenza vaccination of health care workers in hospitals–a review of studies on attitudes and predictors
Vaccine
Non-response bias in a web-based health behaviour survey of New Zealand tertiary students
Prev Med
Impact of influenza exposure on rates of hospital admissions and physician visits because of respiratory illness among pregnant women
CMAJ
Rates and determinants of seasonal influenza vaccination in pregnancy and association with neonatal outcomes
CMAJ
Effectiveness of seasonal trivalent influenza vaccine for preventing influenza virus illness among pregnant women: a population-based case-control study during the 2010-2011 and 2011-2012 influenza seasons
Clin Infect Dis
Effectiveness of maternal influenza immunization in mothers and infants
N Engl J Med
Maternal immunization
N Engl J Med
Maintaining the momentum: key factors influencing acceptance of influenza vaccination among pregnant women following the H1N1 pandemic
Hum Vaccin Immunother
Maternal immunization: clinical experiences, challenges, and opportunities in vaccine acceptance
Hum Vaccin Immunother
Incorporating immunizations into routine obstetric care to facilitate health care practitioners in implementing maternal immunization
Hum Vaccin Immunother
Understanding pregnant women's attitudes and behavior toward influenza and pertussis vaccination
Qual Health Res
Predictors of uptake of influenza vaccination–a survey of pregnant women in Western Australia
Aust Fam Physician
Cited by (22)
Flu and pertussis vaccination during pregnancy in Geneva during the COVID-19 pandemic: A multicentric, prospective, survey-based study
2022, VaccineCitation Excerpt :Recommendations from healthcare professionals play a key role in encouraging vaccination during pregnancy [37], with women often valuing the recommendations and convictions of midwives over that of other health professionals [38]. However, a Canadian survey found that recommendations for influenza vaccination during pregnancy vary among healthcare members, with midwives (38%) being less likely than physicians (80%) to recommend the influenza vaccine to their patients [39]. Since the information often given to patients on maternal vaccination is often affected by personal perceptions, it is essential to educate all healthcare professionals on current guidelines, especially midwives, who have reported little undergraduate training on maternal vaccination [40].
Healthcare providers’ interpretations of product labelling information developed through a consensus stakeholder approach
2021, VaccineCitation Excerpt :Third, midwives and physicians who completed our survey may have been biased towards recommending vaccination in pregnancy. More midwives and physicians in our sample reported that they recommend IIV in pregnancy compared to a larger survey of Canadian HCPs, but a similar proportion of nurses reported recommending IIV in pregnancy in both studies [17]. Finally, our survey is limited to the Canadian context, but findings from a previous study demonstrate similarities in perceptions of vaccine product labelling information among HCPs from other regions, including low- and middle-income countries [23].
The faces of influenza vaccine recommendation: A Literature review of the determinants and barriers to health providers’ recommendation of influenza vaccine in pregnancy
2020, VaccineCitation Excerpt :Provider type was cited as a determinant in studies from Canada, Europe, and Thailand [33,46,51,52], with more frequent recommendations coming from ObGyns, gynecologists or nurses [37] than midwives, except in one study where it was the opposite [50]. Several other studies found that recommendation rates did not vary by provider type [26,38]. Data for determinants in MICs was limited to 4 countries - Thailand, Georgia, China and India; however, consistent determinants from those countries were higher awareness of the vaccination policy, and perceived safety [18,33,34].
Knowledge, attitudes, and practices regarding vaccination among community pharmacists
2022, Primary Health Care Research and Development
Competing interests: See Acknowledgements.