title: Attitudes and Beliefs of Pregnant Women and New Mothers Regarding Influenza Vaccination in British Columbia.
abstract: Although pregnant women have increased risks for influenza morbidity and mortality, influenza vaccination rates among pregnant women in Canada are consistently very low. This mixed-methods study investigated the attitudes and behaviour of pregnant women and new mothers regarding seasonal and pandemic influenza vaccination.
  
  
  
  We conducted a baseline survey and qualitative focus groups with 34 women (26 pregnant women and 8 mothers of newborns), with a follow-up survey to assess outcomes at the end of the subsequent influenza season. Data analysis included descriptive statistics and directed content analysis based on the health belief model.
  
  
  
  Most women did not consider influenza vaccination to be an important preventative measure to take while pregnant, although some were more willing to consider vaccination during a pandemic. Omission bias played a substantial role as justification for not vaccinating. Participants expressed confusion about recommendations regarding vaccination during pregnancy and frustration with inconsistent messages from health care providers (HCPs), particularly with regard to pandemic vaccines. Women were vaccinated when they perceived themselves and/or their babies to be at increased risk for influenza. Vaccinated women had strong normative influences (usually an HCP or a family member) that affected their decision. Intentions accurately predicted behaviour for women who did and did not intend to be vaccinated.
  
  
  
  Pregnant women did not perceive themselves to be at increased risk for influenza and did not believe that influenza vaccination was a necessary preventative health measure. A lack of safety information about vaccination during pregnancy and inconsistent messages from HCPs were barriers to vaccine acceptance. Recommendations from maternity care providers and communication about the severity of and susceptibility to influenza for pregnant women would facilitate vaccine uptake.
authors.affiliation: Vaccine Evaluation Center, BC Children's Hospital, Child and Family Research Institute and University of British Columbia, Vancouver BC; Women's Health Research Institute and University of British Columbia, Vancouver BC.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Bettinger
authors.affiliation: Vaccine Evaluation Center, BC Children's Hospital, Child and Family Research Institute and University of British Columbia, Vancouver BC.
authors.forename: Devon
authors.initials: D
authors.lastname: Greyson
authors.affiliation: Women's Health Research Institute and University of British Columbia, Vancouver BC.
authors.forename: Deborah
authors.initials: D
authors.lastname: Money
mesh_terms: D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007231:Infant, Newborn; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000517:prevention & control; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D037841:Pregnant People / Q000523:psychology*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: immunization; mixed methods; neonates; pregnancy; risk