Influenza vaccination during pregnancy: coverage rates and influencing factors in two urban districts in Sydney.
BACKGROUND
Pregnant women have an increased risk of complications from influenza. Influenza vaccination during pregnancy is considered effective and safe; however estimates of vaccine coverage are low. This study aimed to determine influenza vaccination coverage and factors associated with vaccine uptake in pregnant women in two Sydney-based health districts.


METHODS
A random sample of women who delivered a baby in a public hospital in Sydney and South-Western Sydney Local Health Districts between June and September 2012 were surveyed using a computer assisted telephone interviewing service.


RESULTS
Of the 462 participants (participation rate 92%), 116 (25%) reported receiving the influenza vaccine during their pregnancy. In univariate analysis, vaccination coverage varied significantly depending on antenatal care type, hospital of birth, and parity (p<0.05), but not for age category, highest level of education, country of birth, language spoken at home, or Aboriginal status. Women who received antenatal care through a general practitioner (GP) had 2.3 (95% CI 1.4-3.6) times the odds (unadjusted) of receiving the influenza vaccination than those who received their antenatal care through a public hospital. The main reason cited for vaccination was GP recommendation (37%), while non-recommendation (33%) and lack of knowledge (26%) were cited as main reasons for not receiving the vaccination. 30% of women recalled receiving a provider recommendation for the vaccination and these women had 33.0 times the odds (unadjusted) of receiving the vaccination than women who had not received a recommendation. In a multivariate model a provider recommendation was the only variable that was significantly associated with vaccination (OR 41.9; 95% CI 20.7-84.9).


CONCLUSIONS
Rates of influenza vaccination during pregnancy are low. There is a significant relationship between healthcare provider recommendation for the vaccination and vaccine uptake. Increasing provider recommendation rates has the potential to increase coverage rates of influenza vaccination in pregnant women.
NSW Public Health Officer Training Program, NSW Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia; School of Public Health and Community Medicine, University of New South Wales, UNSW, Sydney 2052, Australia. Electronic address: lmahe@doh.health.nsw.gov.au.
Louise
L
Maher
Kirsty
K
Hope
Siranda
S
Torvaldsen
Glenda
G
Lawrence
Angela
A
Dawson
Kerrie
K
Wiley
Deborah
D
Thomson
Andrew
A
Hayen
Stephen
S
Conaty
D000328:Adult; D001315:Australia; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007231:Infant, Newborn; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D007407:Interviews as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D011897:Random Allocation; D014505:Urban Population; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
D007252:Influenza Vaccines
Influenza; Pregnancy; Provider recommendation; Vaccine