title: Factors associated with seasonal influenza vaccination in pregnant women.
abstract: BACKGROUND
  This observational study followed a cohort of pregnant women during the 2010-2011 influenza season to determine factors associated with vaccination.
  
  
  METHODS
  Participants were 1105 pregnant women who completed a survey assessing health beliefs related to vaccination upon enrollment and were then followed to determine vaccination status by the end of the 2010-2011 influenza season. We conducted univariate and multivariate analyses to explore factors associated with vaccination status and a factor analysis of survey items to identify health beliefs associated with vaccination.
  
  
  RESULTS
  Sixty-three percent (n=701) of the participants were vaccinated. In the univariate analyses, multiple factors were associated with vaccination status, including maternal age, race, marital status, educational level, and gravidity. Factor analysis identified two health belief factors associated with vaccination: participant's positive views (factor 1) and negative views (factor 2) of influenza vaccination. In a multivariate logistic regression model, factor 1 was associated with increased likelihood of vaccination (adjusted odds ratio [aOR]=2.18; 95% confidence interval [CI]=1.72-2.78), whereas factor 2 was associated with decreased likelihood of vaccination (aOR=0.36; 95% CI=0.28-0.46). After controlling for the two health belief factors in multivariate analyses, demographic factors significant in univariate analyses were no longer significant. Women who received a provider recommendation were about three times more likely to be vaccinated (aOR=3.14; 95% CI=1.99-4.96).
  
  
  CONCLUSIONS
  Pregnant women's health beliefs about vaccination appear to be more important than demographic and maternal factors previously associated with vaccination status. Provider recommendation remains one of the most critical factors influencing vaccination during pregnancy.
authors: 1 Center for Health Research , Kaiser Permanente Northwest, Portland, OR.
authors: Michelle L
authors: ML
authors: Henninger
authors: Stephanie A
authors: SA
authors: Irving
authors: Mark
authors: M
authors: Thompson
authors: Lyndsay Ammon
authors: LA
authors: Avalos
authors: Sarah W
authors: SW
authors: Ball
authors: Pat
authors: P
authors: Shifflett
authors: Allison L
authors: AL
authors: Naleway
mesh_terms: D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage; D007251:Influenza, Human / Q000517:prevention & control*; D016015:Logistic Models; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D037841:Pregnant People; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines