Influenza vaccination in pregnant women: Why do they get or not the shot? Sacristan M, Alvarez-Pasquin MJ

Transcription

1 Influenza vaccination in pregnant women: Why do they get or not the shot? Sacristan M, Alvarez-Pasquin MJ Eurovaccine, Dec 2010

2 Introduction- Objectives Pregnancy is a risk group for complicated influenza. The influenza vaccine is an effective, safe and efficient preventive measure. However, pregnant women are a hard to reach group for influenza vaccination. Our objective is to compare the rate of influenza vaccination among pregnant women compared to fertile non pregnant women with risk factors, and to describe why pregnant women get or don t get influenza vaccination.

3 Material and methods Design: descriptive study using database and survey Population: 430 women aged 18-45y, from an urban primary care centre in Madrid with risk factors for influenza in (130 pregnant, 300 not) Variables demographic characteristics, risk factors, vaccination status, reasons for being vaccinated/not, professional advice received/not, general opinion about vaccination during pregnancy Statistical analysis: we compared qualitative variables by chi square test. Results of our surveys by descriptive analysis

4 Results I: vaccination rates 85% Global vaccination rate Total women: % Vaccinated women Non vaccinated women Vaccination rate according to pregnancy status RISK FACTOR TOTAL WOMEN Vaccinated (%) Pregnancy only Asthma Pregnancy and asthma Pregnancy and other risk factors without pregnancy Respiratory, not asthma Diabetes Cardiovascular Not vaccinated (%) 132 Pregnant 298 Non pregnant 8,3%/91,7% Vaccinated Non vaccinated 18,1%/81,9% Immunosuppression Other chronics Professional risk TOTAL Global vaccination rate: 15%. (8,3% in pregnant, 18,1% in non pregnant) Vaccination rate Ratio (pregnant/not): 0,46 (0,25-0,85) p 0,008

5 Results II: reasons for getting or not the shot Why these 14 women DID GET the shot? Our survey was answered by 43 pregnant women (14 vaccinated, 29 not) a b c d e Why these 29 women DID NOT get the shot? a b c d e f g h i j a = I always get it b = I asked for it c = I was adviced by my doctor/nurse d = Information from tv, campaings e = Information from internet a = I never get it b = I dont need it c = I am afraid of needles d = I am afraid of secondary effects e = No professional recommended me to get it f = Some professionals recommended me not to get it g = Negative information in tv, campaings h = Negative information in internet i = I had no time j = I was afraid it could harm my baby

6 Results III: professional advice Family doctor Professional POSITIVE advice in last 5 years Midwife Gynecologist Other doctor Nurse Nobody 26 Vaccination according to professional advice received Without advice 2 21 With advice 12 8 Vaccinated Not vaccinated Professional NEGATIVE advice in last 5 years Nobody Other doctor Gynecologist Family doctor Nurse Midwife Women that had professional advice for vaccination were 6,9 times more vaccinated than those who didn t received it (1,75-27,2) p=0,

7 Results IV: general knowledge General opinion about vaccination during pregnancy 44% 21% 0% 5% 30% Vaccines should generally be avoided during pregnancy Vaccines are recommended during pregnancy It depends. Influenza vaccine is recommended It depends. Influenza vaccine should be avoided I dont know

8 Discussion Reasons for not getting the vaccine in our survey coincide with bibliography. Both show lack of advice from gynecologists to pregnant women. Another important factor is insufficient knowledge among population about immunization and pregnancy. There is the need for improving knowledge among professionals and general population.

9 Conclusions Influenza vaccination rate is generally low in risk groups. Rate decreases during pregnancy. Pregnant women receive little advice for vaccination from professionals, specially from gynecologists. There is little knowledge about recommendations about vaccination during pregnancy.