title: Trends in seasonal influenza vaccine uptake during pregnancy in Western Australia: Implications for midwives.
abstract: BACKGROUND
  Antenatal influenza vaccination is an important public health intervention for preventing serious illness in mothers and newborns, yet uptake remains low.
  
  
  OBJECTIVE
  To evaluate trends in seasonal influenza vaccine coverage and identify determinants for vaccination among pregnant women in Western Australia.
  
  
  METHODS
  We conducted an annual telephone survey in a random sample of post-partum women who delivered a baby in Western Australia between 2012 and 2014. Women were asked whether influenza vaccination was recommended and/or received during their most recent pregnancy; women were also asked why or why they were not immunised.
  
  
  RESULTS
  Between 2012 and 2014, influenza vaccine coverage increased from 22.9% to 41.4%. Women who reported receiving the majority of their antenatal care from a private obstetrician were significantly more likely to have influenza vaccination recommended to them than those receiving the majority of their care from a public antenatal hospital or general practitioner (p<0.001). In 2014, the most common reason women reported for accepting influenza vaccination was to protect the baby (92.8%) and the most common reason for being unimmunised was lack of a healthcare provider recommendation (48.5%).
  
  
  CONCLUSIONS
  Antenatal influenza vaccination uptake is increasing, but coverage remains below 50%. A recommendation from the principal care provider is an important predictor of maternal influenza vaccination.
  
  
  CONCLUSIONS
  Antenatal care providers, including midwives, have a key role in providing appropriate information and evidence-based recommendations to pregnant women to ensure they are making informed decisions. Consistent recommendations from antenatal care providers are critical to improving influenza vaccine coverage in pregnant women.
authors.affiliation: School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, Australia; Communicable Disease Control Directorate, Western Australia Department of Health, Shenton Park, Western Australia, Australia. Electronic address: Annette.Regan@health.wa.gov.au.
authors.forename: Annette K
authors.initials: AK
authors.lastname: Regan
authors.affiliation: Communicable Disease Control Directorate, Western Australia Department of Health, Shenton Park, Western Australia, Australia.
authors.forename: Donna B
authors.initials: DB
authors.lastname: Mak
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Western Australia, Australia; Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia.
authors.forename: Yvonne L
authors.initials: YL
authors.lastname: Hauck
authors.affiliation: Communicable Disease Control Directorate, Western Australia Department of Health, Shenton Park, Western Australia, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Gibbs
authors.affiliation: Communicable Disease Control Directorate, Western Australia Department of Health, Shenton Park, Western Australia, Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Tracey
authors.affiliation: School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, Australia; Communicable Disease Control Directorate, Western Australia Department of Health, Shenton Park, Western Australia, Australia.
authors.forename: Paul V
authors.initials: PV
authors.lastname: Effler
mesh_terms: D000328:Adult; D005260:Female; D019538:Health Care Surveys; D006282:Health Personnel; D006779:Hospitals, Public; D006801:Humans; D007231:Infant, Newborn; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D008880:Midwifery; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D037841:Pregnant People; D011295:Prenatal Care / Q000639:trends*; D012621:Seasons; D014611:Vaccination / Q000706:statistics & numerical data / Q000639:trends*; D014904:Western Australia
chemical_list: D007252:Influenza Vaccines
keywords: Antenatal vaccination; Influenza vaccine; Maternal health; Maternal vaccination; Pregnant woman