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Vaccination Against Influenza in Pregnancy: A Survey of Canadian Maternity Care Providers

Published:November 06, 2018DOI:https://doi.org/10.1016/j.jogc.2018.09.007

      Abstract

      Objective

      Influenza vaccine uptake among Canadian pregnant individuals is suboptimal. Failure to incorporate vaccination into routine prenatal care and a lack of recommendations from healthcare providers are recognized as barriers to vaccination. The aim of this study was to assess Canadian maternity care providers’ knowledge, attitudes, and practices regarding influenza vaccination in pregnancy.

      Methods

      A cross-sectional Web-based questionnaire was sent during July and August 2017 to family physicians, obstetricians-gynaecologists, midwives, pharmacists, and nurses who care for pregnant individuals. A multivariable logistic regression model was used to determine variables independently associated with providers’ recommendation of the influenza vaccine in pregnancy.

      Results

      The analysis included 1061 providers. Most participants (85%) reported being vaccinated against influenza themselves, and 72% reported recommending the influenza vaccine to all of their pregnant patients during the previous influenza season. Participants’ attitudes regarding influenza vaccination during pregnancy were generally positive: 64% strongly agreed that pregnant individuals are at an increased risk of complications from influenza, and 69% strongly agreed that it is safe to vaccinate pregnant individuals against influenza. The main determinants of participants’ recommendations for influenza vaccination to all pregnant patients were following official recommendations on influenza vaccination, discussing vaccines with most or all pregnant individuals seen in their practice, and being vaccinated themselves during the previous influenza season.

      Conclusion

      Enhancing influenza vaccine uptake in pregnancy is largely dependent on maternity care providers’ recommendations. This study provides valuable insight on providers’ knowledge, attitudes, and practices.

      Résumé

      Objectif

      Le taux de vaccination contre la grippe des femmes enceintes canadiennes est sous optimal. La non-intégration de la vaccination aux soins prénataux de base et l'absence de recommandations des fournisseurs de soins de santé sont des obstacles connus à la vaccination. Cette étude visait à évaluer les connaissances, les attitudes et les pratiques des fournisseurs canadiens de soins de maternité à l'égard de la vaccination contre la grippe durant la grossesse.

      Méthodologie

      Un questionnaire transversal en ligne a été envoyé en juillet et août 2017 à des médecins de famille, obstétriciens, gynécologues, sages-femmes, pharmaciens et infirmiéres qui prennent soin de femmes enceintes. Un modéle de régression logistique multivariée a été utilisé pour mettre en évidence des variables indépendamment associées à la recommandation du vaccin antigrippal durant la grossesse par les fournisseurs.

      Résultats

      L'analyse comprenait 1 061 fournisseurs. La plupart des participants (85 %) ont indiqué être eux-mêmes vaccinés contre la grippe, et 72 % ont dit avoir recommandé le vaccin antigrippal à toutes leurs patientes enceintes durant la saison de la grippe précédente. Les attitudes des participants à l'égard de la vaccination contre la grippe durant la grossesse étaient généralement positives : 64 % étaient tout à fait d'accord pour dire que les femmes enceintes présentent un risque accru de complications grippales, et 69 % étaient tout à fait d'accord pour dire qu'il est sécuritaire de vacciner les femmes enceintes contre la grippe. Les principaux critéres déterminant si le participant recommandait la vaccination contre la grippe à toutes ses patientes enceintes étaient le respect des recommandations officielles à ce sujet, les discussions sur les vaccins avec la plupart ou la totalité des femmes enceintes qui les consultaient et le fait d'avoir été eux-mêmes vaccinés durant la saison de la grippe précédente.

      Conclusions

      L'augmentation du taux de vaccination contre la grippe durant la grossesse repose largement sur les recommandations des fournisseurs de soins de maternité. Cette étude fournit des renseignements précieux sur les connaissances, les attitudes et les pratiques des fournisseurs.

      Key Words

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