Influenza vaccination during pregnancy - Patients' and physicians' attitudes

Objective: To identify potentially remediable attitudinal factors among wom en and their physicians that may present barriers to influenza vaccination during pregnancy. Study design: We conducted a prospective survey study administered concurre ntly during influenza season (January-March 2000) to postpartum women in an urban, high-volume medical center and to practicing obstetricians in the m etropolitan Los Angeles area. Analyses focused on individual questions' rel ation to the outcomes of. (1) patients' receipt of influenza vaccine during the recently completed pregnancy, and (2) physicians' discussion of influe nza Vaccine with their pregnant patients. Results: Surveys were completed by 242 postpartum women and 113 physicians. Among the women, 22% had discussed influenza vaccine with their physicians during pregnancy, with only 8% of respondents having been vaccinated. Sign ificantly more physicians stated that they discussed vaccination with their patients than did women (74% vs. 22%; P<.001). Physicians were more likely to recommend vaccine if they were aware of current Centers for Disease Pre vention and Control guidelines (RR = 2.6, 1.1-5.9), gave vaccinations in th eir offices (RR = 1.2, 1.01-1.4) and had been vaccinated against influenza themselves (RR=1.9, 1.3-2.8). Conclusion: Influenza vaccination during pregnancy occurred infrequently in this study cohort, and a significant discrepancy was seen between patients ' and physicians' impressions of whether its use or recommendation had been discussed. Gaps existed in both groups' understanding of potential benefit s of influenza vaccine for both pregnant women and their newborns. The surv ey results suggest potential strategies for targeting improved educational programs for physicians and patients to improve influenza vaccination rates for pregnant women.