title: Prevalence and predictors of maternal seasonal influenza vaccination in Hong Kong.
abstract: BACKGROUND
  Pregnant women infected with influenza virus are more likely to experience severe complications when compared with their non-pregnant peers. Yet influenza vaccine uptake is low among pregnant women. The purpose of this study was to assess the prevalence of seasonal influenza vaccine uptake among pregnant women in Hong Kong and to identify predictors of vaccine uptake.
  
  
  METHODS
  Using a multi-center cross-sectional design, we recruited 2822 new mothers during their immediate postpartum stay from all eight public obstetric hospitals in Hong Kong. We assessed antenatal maternal influenza vaccination status as well as health beliefs and perceptions toward influenza and influenza vaccination. Bivariable and multivariable logistic regression was used to identify the predictors of vaccination uptake.
  
  
  RESULTS
  Only 49 (1.7%; 95% CI 1.3-2.3%) participants were vaccinated during their pregnancy. Fear that the vaccine would cause harm to the fetus or themselves were the most common reasons for not being vaccinated. Being aware of the vaccination recommendations (OR=2.69; 95% CI 1.06-6.82), being advised by a health-care provider (OR=6.30; 95% CI 3.19-12.46), history of vaccination (OR=2.47; 95% CI 1.25-4.91), perceived susceptibility to influenza infection (OR=3.67; 95% CI 1.64-8.22), and perceived benefits of influenza vaccination (OR=9.98; 95% CI 3.79-26.24) were all independently associated with vaccination. Perceived barriers to vaccination (OR=0.17; 95% CI 0.07-0.40) were strongly associated with failure to vaccinate.
  
  
  CONCLUSIONS
  Low seasonal influenza vaccination uptake among Hong Kong pregnant women was related to a number of factors, all of which are amenable to interventions. Vaccination promotion strategies need to focus on encouraging health-care providers to discuss vaccination with their pregnant clients and in providing pregnant women with accurate and unbiased information about the risks of influenza infection and the benefits of vaccination.
authors.affiliation: School of Nursing, Li Ka Shing Faculty of Medicine, 21 Sassoon Road, Pokfulam, Hong Kong. Electronic address: carol_iou@hotmail.com.
authors.forename: Carol
authors.initials: C
authors.lastname: Yuet Sheung Yuen
authors.forename: Daniel
authors.initials: D
authors.lastname: Yee Tak Fong
authors.forename: Irene
authors.initials: I
authors.lastname: Lai Yin Lee
authors.forename: Sing
authors.initials: S
authors.lastname: Chu
authors.forename: Esther
authors.initials: E
authors.lastname: Sau-mei Siu
authors.forename: Marie
authors.initials: M
authors.lastname: Tarrant
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D014611:Vaccination; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: Health belief model; Health beliefs; Hong Kong; Influenza vaccine; Pregnant women; Seasonal influenza; Vaccination