Coverage and determinants of influenza vaccine among pregnant women: a cross-sectional study

Abstract Background Pregnant women are at increased risk of influenza-related complications. The World Health Organisation recommends influenza vaccination to this high-risk population as highest priority. However, achieving high influenza vaccine coverage among pregnant women remains challenging. W...

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Main Authors: Vittoria Offeddu, Clarence C. Tam, Tze Tein Yong, Lay Kok Tan, Koh Cheng Thoon, Nicole Lee, Thiam Chye Tan, George S. H. Yeo, Chee Fu Yung
Format: Article
Language:English
Published: BMC 2019-07-01
Series:BMC Public Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12889-019-7172-8
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author Vittoria Offeddu
Clarence C. Tam
Tze Tein Yong
Lay Kok Tan
Koh Cheng Thoon
Nicole Lee
Thiam Chye Tan
George S. H. Yeo
Chee Fu Yung
author_facet Vittoria Offeddu
Clarence C. Tam
Tze Tein Yong
Lay Kok Tan
Koh Cheng Thoon
Nicole Lee
Thiam Chye Tan
George S. H. Yeo
Chee Fu Yung
author_sort Vittoria Offeddu
collection DOAJ
description Abstract Background Pregnant women are at increased risk of influenza-related complications. The World Health Organisation recommends influenza vaccination to this high-risk population as highest priority. However, achieving high influenza vaccine coverage among pregnant women remains challenging. We conducted a cross-sectional survey to estimate the coverage and determinants of influenza vaccination among pregnant women in Singapore. Methods Between September and November 2017, pregnant women aged ≥21 years were recruited at two public hospitals in Singapore. Participants completed an anonymous, self-administered online questionnaire assessing participants’ influenza vaccination uptake, knowledge of and attitudes towards influenza and the influenza vaccine, vaccination history, willingness to pay for the influenza vaccine, and external cues to vaccination. We estimated vaccine coverage and used multivariable Poisson models to identify factors associated with vaccine uptake. Results Response rate was 61% (500/814). Only 49 women (9.8, 95% Confidence Interval (CI): 7.3–12.7%) reported receiving the vaccine during their current pregnancy. A few misconceptions were identified among participants, such as the belief that influenza can be treated with antibiotics. The most frequent reason for not being vaccinated was lack of recommendation. Women who were personally advised to get vaccinated against influenza during pregnancy were 7 times more likely to be vaccinated (prevalence ratio (PR) = 7.11; 95% CI: 3.92–12.90). However, only 12% of women were personally advised to get vaccinated. Other factors associated with vaccine uptake were vaccination during a previous pregnancy (PR = 2.51; 95% CI: 1.54–4.11), having insurance to cover the cost of the vaccine (PR = 2.32; 95% CI: 1.43–3.76), and higher vaccine confidence (PR = 1.62; 95% CI: 1.30–2.01). Conclusions Influenza vaccination uptake among pregnant women in Singapore is low. There is considerable scope for improving vaccination coverage in this high-risk population through vaccination recommendations from healthcare professionals, and public communication targeting common misconceptions about influenza and influenza vaccines.
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spelling doaj.art-ac1c2f60cb1747edb6009058288151d92022-12-21T23:34:45ZengBMCBMC Public Health1471-24582019-07-0119111210.1186/s12889-019-7172-8Coverage and determinants of influenza vaccine among pregnant women: a cross-sectional studyVittoria Offeddu0Clarence C. Tam1Tze Tein Yong2Lay Kok Tan3Koh Cheng Thoon4Nicole Lee5Thiam Chye Tan6George S. H. Yeo7Chee Fu Yung8Saw Swee Hock School of Public Health, National University of Singapore and National University Health SystemSaw Swee Hock School of Public Health, National University of Singapore and National University Health SystemSingapore General HospitalSingapore General HospitalKK Women’s and Children’s HospitalKK Women’s and Children’s HospitalKK Women’s and Children’s HospitalKK Women’s and Children’s HospitalKK Women’s and Children’s HospitalAbstract Background Pregnant women are at increased risk of influenza-related complications. The World Health Organisation recommends influenza vaccination to this high-risk population as highest priority. However, achieving high influenza vaccine coverage among pregnant women remains challenging. We conducted a cross-sectional survey to estimate the coverage and determinants of influenza vaccination among pregnant women in Singapore. Methods Between September and November 2017, pregnant women aged ≥21 years were recruited at two public hospitals in Singapore. Participants completed an anonymous, self-administered online questionnaire assessing participants’ influenza vaccination uptake, knowledge of and attitudes towards influenza and the influenza vaccine, vaccination history, willingness to pay for the influenza vaccine, and external cues to vaccination. We estimated vaccine coverage and used multivariable Poisson models to identify factors associated with vaccine uptake. Results Response rate was 61% (500/814). Only 49 women (9.8, 95% Confidence Interval (CI): 7.3–12.7%) reported receiving the vaccine during their current pregnancy. A few misconceptions were identified among participants, such as the belief that influenza can be treated with antibiotics. The most frequent reason for not being vaccinated was lack of recommendation. Women who were personally advised to get vaccinated against influenza during pregnancy were 7 times more likely to be vaccinated (prevalence ratio (PR) = 7.11; 95% CI: 3.92–12.90). However, only 12% of women were personally advised to get vaccinated. Other factors associated with vaccine uptake were vaccination during a previous pregnancy (PR = 2.51; 95% CI: 1.54–4.11), having insurance to cover the cost of the vaccine (PR = 2.32; 95% CI: 1.43–3.76), and higher vaccine confidence (PR = 1.62; 95% CI: 1.30–2.01). Conclusions Influenza vaccination uptake among pregnant women in Singapore is low. There is considerable scope for improving vaccination coverage in this high-risk population through vaccination recommendations from healthcare professionals, and public communication targeting common misconceptions about influenza and influenza vaccines.http://link.springer.com/article/10.1186/s12889-019-7172-8InfluenzaInfluenza vaccineMaternal vaccinationPregnancyVaccine recommendation
spellingShingle Vittoria Offeddu
Clarence C. Tam
Tze Tein Yong
Lay Kok Tan
Koh Cheng Thoon
Nicole Lee
Thiam Chye Tan
George S. H. Yeo
Chee Fu Yung
Coverage and determinants of influenza vaccine among pregnant women: a cross-sectional study
BMC Public Health
Influenza
Influenza vaccine
Maternal vaccination
Pregnancy
Vaccine recommendation
title Coverage and determinants of influenza vaccine among pregnant women: a cross-sectional study
title_full Coverage and determinants of influenza vaccine among pregnant women: a cross-sectional study
title_fullStr Coverage and determinants of influenza vaccine among pregnant women: a cross-sectional study
title_full_unstemmed Coverage and determinants of influenza vaccine among pregnant women: a cross-sectional study
title_short Coverage and determinants of influenza vaccine among pregnant women: a cross-sectional study
title_sort coverage and determinants of influenza vaccine among pregnant women a cross sectional study
topic Influenza
Influenza vaccine
Maternal vaccination
Pregnancy
Vaccine recommendation
url http://link.springer.com/article/10.1186/s12889-019-7172-8
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