Acceptability of maternal immunization against influenza: the critical role of obstetricians
Acceptability of maternal immunization against influenza: the critical role of obstetricians
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DOI：
10.3109/14767058.2012.663835
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发表时间：
2012-09-01
影响因子：
1.8
通讯作者：
Siegrist, Claire-Anne
中科院分区：
文献类型：
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作者：
Blanchard-Rohner, Geraldine;Meier, Sara;Siegrist, Claire-Anne
孕妇和婴儿因流感发生疫苗可预防并发症的风险增加。瑞士于2009年首次向所有孕妇推荐免疫接种。我们在两个季节后评估了该建议的可接受性及其决定因素。方法：要求2011年3月期间在日内瓦大学医院分娩的妇女填写一份调查问卷，评估她们在怀孕期间对流感疫苗接种的知识、信念和可接受性。结果：323名女性中有261人（80%）完成了问卷调查。在261人中，213人（82%）知道怀孕期间流感风险增加，119人（46%）知道建议在怀孕期间接种疫苗。只有110/261（42%）的人回忆在怀孕期间接受过免疫建议，只有47/261（18%）的人接种过疫苗。直接推荐是免疫接种的主要预测因素，与接种疫苗的可能性增加107倍有关。通过多变量分析确定的与免疫可能性独立相关的因素包括：曾被私人（OR 9.1）或医院（OR 4.7）产科医生而不是助产士推荐免疫接种，不担心免疫接种会导致早产（OR 0.3），以及在前几年接种过免疫接种（OR 10.7）。结论：在建议怀孕期间接种流感疫苗两年后，大多数产后妇女回忆说，既没有被建议接种流感疫苗，也没有被充分告知流感疫苗及其安全性。该研究确定了卫生保健工作者在认识和/或沟通方面的主要差距，并建议提高产科医生对免疫接种安全性/有效性的认识是提高妊娠期间流感免疫接种的最有可能的方法。
Introduction: Pregnant women and infants are at increased risk of vaccine-preventable complications due to influenza. In Switzerland, immunization was first recommended to all pregnant women in 2009. We assessed the acceptability of this recommendation and its determinants two seasons later. Methods: Women having delivered in the University Hospitals of Geneva during March 2011 were asked to fill in a questionnaire assessing their knowledge, beliefs and acceptability of influenza vaccination during pregnancy. Results: The questionnaire was completed by 261/323 (80%) women. Out of 261, 213 (82%) were aware of increased risks of influenza during pregnancy, and 119/261 (46%) knew that immunization was recommended during pregnancy. Only 110/261 (42%) recalled an immunization advise during their pregnancy and only 47/261 (18%) had been immunized. A direct recommendation was the main predictor of immunization, associated with a 107-fold increased likelihood of vaccination. Factors identified by multivariate analyses as independently associated with the likelihood of immunization were to have been recommended immunization by a private (OR 9.1) or hospital (OR 4.7) obstetrician rather than a midwife, to have no fear that immunization could cause preterm delivery (OR 0.3) and to have been immunized in previous years (OR 10.7). Conclusion: Two years after the recommendation of influenza immunization during pregnancy, most post-partum women recalled being neither recommended nor adequately informed about influenza vaccine and its safety. This identifies major gaps in awareness and/or communication in healthcare workers and suggests that improving immunization safety/efficacy awareness among obstetricians as the most likely method to improve flu immunization during pregnancy.