Influenza vaccination during pregnancy. Patients' and physicians' attitudes.
OBJECTIVE
To identify potentially remediable attitudinal factors among women and their physicians that may present barriers to influenza vaccination during pregnancy.


METHODS
We conducted a prospective survey study administered concurrently during influenza season (January-March 2000) to postpartum women in an urban, high-volume medical center and to practicing obstetricians in the metropolitan Los Angeles area. Analyses focused on individual questions' relation to the outcomes of: (1) patients' receipt of influenza vaccine during the recently completed pregnancy, and (2) physicians' discussion of influenza vaccine with their pregnant patients.


RESULTS
Surveys were completed by 242 postpartum women and 113 physicians. Among the women, 22% had discussed influenza vaccine with their physicians during pregnancy, with only 8% of respondents having been vaccinated. Significantly more physicians stated that they discussed vaccination with their patients than did women (74% vs. 22%; P < .001). Physicians were more likely to recommend vaccine if they were aware of current Centers for Disease Prevention and Control guidelines (RR = 2.6, 1.1-5.9), gave vaccinations in their offices (RR = 1.2, 1.01-1.4) and had been vaccinated against influenza themselves (RR = 1.9, 1.3-2.8).


CONCLUSIONS
Influenza vaccination during pregnancy occurred infrequently in this study cohort, and a significant discrepancy was seen between patients' and physicians' impressions of whether its use or recommendation had been discussed. Gaps existed in both groups' understanding of potential benefits of influenza vaccine for both pregnant women and their newborns. The survey results suggest potential strategies for targeting improved educational programs for physicians and patients to improve influenza vaccination rates for pregnant women.
Silverman
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Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Burns & Allen Research Institute, University of California, Los Angeles School of Medicine, Los Angeles, USA. silvermann.cshs.org
Greif
A
A
D000328:Adult; D001291:Attitude of Health Personnel; D015331:Cohort Studies; D003625:Data Collection; D005260:Female; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D010817:Physician-Patient Relations; D011247:Pregnancy; D011446:Prospective Studies
D007252:Influenza Vaccines