title: Increasing uptake of influenza vaccine by pregnant women post H1N1 pandemic: a longitudinal study in Melbourne, Australia, 2010 to 2014.
abstract: BACKGROUND
  A Melbourne (Australia) university affiliated, tertiary obstetric hospital provides lay and professional education about influenza vaccine in pregnancy annually each March, early in the local influenza season. Responding to a 2011 survey of new mothers' opinions, the hospital made influenza vaccine freely available in antenatal clinics from 2012. We wished to determine influenza vaccination uptake during pregnancy with these strategies 5 years after 2009 H1N1.
  
  
  METHODS
  Face to face interviews based on US Center for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System with new mothers in postnatal wards each July, 2010 to 2014. We calculated recalled influenza vaccine uptake each year and assessed trends with chi square tests, and logistic regression.
  
  
  RESULTS
  We recorded 1086 interviews. Influenza vaccination during pregnancy increased by 6% per year (95% confidence interval 4 to 8%): from 29.6% in 2010 to 51.3% in 2014 (p < 0.001). Lack of discussion from maternity caregivers was a persistent reason for non-vaccination, recalled by 1 in 2 non-vaccinated women. Survey respondents preferred face to face consultations with doctors and midwives, internet and text messaging as information sources about influenza vaccination. Survey responses indicate messages about vaccine safety in pregnancy and infant benefits are increasingly being heeded. However, there was progressively lower awareness of maternal benefits of influenza vaccination, especially for women with risk factors for severe disease.
  
  
  CONCLUSIONS
  We observed improving influenza vaccination during pregnancy. There is potential to integrate technology such as text message or internet with antenatal consultations to increase vaccination coverage further.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Melbourne, Level 3, Mercy Hospital for Women, 163 Studley Road, Heidelberg, Victoria, 3084, Australia. eamcca@unimelb.edu.au.
authors.forename: Elizabeth Anne
authors.initials: EA
authors.lastname: McCarthy
authors.affiliation: La Trobe University, Midwifery and Neonatal Nursing Professorial Unit, Level 2, Mercy Hospital for Women, 163 Studley Road, Heidelberg, Victoria, 3084, Australia. W.Pollock@latrobe.edu.au.
authors.forename: Wendy Elizabeth
authors.initials: WE
authors.lastname: Pollock
authors.affiliation: Obstetrics Registrar, Mercy Hospital for Women, 163 Studley Road, Heidelberg, Victoria, 3084, Australia. lauren.e.tapper@gmail.com.
authors.forename: Lauren
authors.initials: L
authors.lastname: Tapper
authors.affiliation: Infection Control Co-ordinator, Level 5, Mercy Hospital for Women, 163 Studley Road, Heidelberg, Victoria, 3084, Australia. MSommerville@mercy.com.au.
authors.forename: Maree
authors.initials: M
authors.lastname: Sommerville
authors.affiliation: La Trobe University, Midwifery and Neonatal Nursing Professorial Unit, Level 2, Mercy Hospital for Women, 163 Studley Road, Heidelberg, Victoria, 3084, Australia. S.McDonald@latrobe.edu.au.
authors.forename: Susan
authors.initials: S
authors.lastname: McDonald
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D016015:Logistic Models; D008137:Longitudinal Studies; D058873:Pandemics; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000379:methods; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D062606:Tertiary Care Centers; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines