title: Influenza during pregnancy: Incidence, vaccination coverage and attitudes toward vaccination in the French web-based cohort G-GrippeNet.
abstract: BACKGROUND
  Pregnancy is a risk factor for severe influenza. However, data on influenza incidence during pregnancy are scarce. Likewise, no data are available on influenza vaccine coverage in France since national recommendation in 2012. We aimed to assess these points using a novel nationwide web-based surveillance system, G-GrippeNet.
  
  
  METHODS
  During the 2014/2015 influenza season, pregnant women living in metropolitan France were enrolled through a web platform (https://www.grippenet.fr/). Throughout the season, participants were asked to report, on a weekly basis, if they had experienced symptoms of influenza-like-illness (ILI). ILI episodes reported were used to calculate incidence density rates based on period of participation from each participant. Vaccination coverage was estimated after weighing on age and education level from national data on pregnant women. Factors associated with higher vaccination coverage were obtained through a logistic regression with Odds Ratio (OR) corrected with the Zhang and Yu method.
  
  
  RESULTS
  A total of 153 women were enrolled. ILI incidence density rate was 1.8 per 100 person-week (95% CI, 1.5-2.1). This rate was higher in women older than 40 years (RR = 3.0, 95% CI [1.1-8.3], p = 0.03) and during first/second trimesters compared to third trimester (RR = 4.0, 95% CI [1.4-12.0], p = 0.01). Crude vaccination coverage was 39% (95% CI, 31-47) and weighted vaccination coverage was estimated at 26% (95% CI, 20-34). Health care provider recommendation for vaccination (corrected OR = 7.8; 95% CI [3.0-17.1]) and non-smoking status (cOR = 2.1; 95% CI [1.2-6.9]) were associated with higher vaccine uptake.
  
  
  CONCLUSIONS
  This original web based longitudinal surveillance study design proved feasible in pregnant women population. First results are of interest and underline that public health policies should emphasize the vaccination promotion through health care providers.
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France; Department of Infectious Diseases, CIC Cochin-Pasteur, Cochin Broca Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; INSERM CIC 1417, Paris, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Loubet
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Guerrisi
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.
authors.forename: Clément
authors.initials: C
authors.lastname: Turbelin
authors.affiliation: INSERM U 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Blondel
authors.affiliation: Department of Infectious Diseases, CIC Cochin-Pasteur, Cochin Broca Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; INSERM CIC 1417, Paris, France; INSERM U 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France; Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Launay
authors.affiliation: Clinical Investigation Center (CIC) INSERM 1432; Gynecology and Obstetrics CIC Network (GO-CIC) & Hepato-gastroenterology Department, Dijon Hospital, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Bardou
authors.affiliation: INSERM U 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France; Department of Obstetrics and Gynecology, Cochin Broca Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Goffinet
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Colizza
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hanslik
authors.affiliation: Department of Infectious Diseases, CIC Cochin-Pasteur, Cochin Broca Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; INSERM CIC 1417, Paris, France; INSERM U 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France. Electronic address: solen.kerneis@aphp.fr.
authors.forename: Solen
authors.initials: S
authors.lastname: Kernéis
mesh_terms: D000328:Adult; D005260:Female; D005602:France / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control; D020407:Internet; D008137:Longitudinal Studies; D008875:Middle Aged; D011159:Population Surveillance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000517:prevention & control; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Attitudes; Incidence; Influenza; Pregnancy; Surveillance; Vaccination