Theory-based predictors of influenza vaccination among pregnant women

Background: Guidelines recommend influenza vaccination for pregnant women, but vaccine uptake in this population is far below the goal set by Healthy People 2020. The purpose of this study was to examine predictors of seasonal influenza vaccination among pregnant women.

Methods: Between 2009 and 2012, the Vaccines and Medications in Pregnancy Surveillance System (VAMPSS) conducted a prospective cohort study of influenza vaccine safety among pregnant women in the US and Canada that oversampled vaccinated women. Data for the present paper are from an additional cross-sectional telephone survey completed during the 2010-2011 influenza season. We examined predictors of influenza vaccination, focusing on Health Belief Model (HBM) constructs.

Results: We surveyed 199 pregnant women, 81% of whom had received a seasonal influenza vaccine. Vaccination was more common among women who felt more susceptible to influenza (OR=1.82, 95% CI 1.10-3.01), who perceived greater vaccine effectiveness (OR=3.92, 95% CI 1.48-10.43), and whose doctors recommended they have flu shots (OR=3.06, 95% CI 1.27-7.38). Those who perceived greater barriers of influenza vaccination had lower odds of vaccination (OR=0.19, 95% CI 0.05-0.75). Perceived social norms, anticipated inaction regret, and worry also predicted uptake, though demographic characteristics of respondents did not.

Conclusion: The HBM provides a valuable framework for exploring influenza vaccination among pregnant women. Our results suggest several potential areas of intervention to improve vaccination rates.