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Patient barriers, not provider knowledge, limit uptake of maternal influenza vaccine
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Most providers of prenatal care routinely recommend the influenza vaccine to pregnant women, suggesting that barriers to vaccination may exist primarily at the patient level, according to recent findings.
In a cross-sectional, self-administered survey, researchers interviewed a random sample (n=496) of obstetricians and family physicians in Oregon. The study, conducted from September to December 2011, addressed questions pertaining to the 2010-2011 influenza season. The survey sought information on the providers’ practice and workflow characteristics, recent histories of providing prenatal care, and their attitudes toward offering the influenza vaccine to pregnant women. They provided information about the gestation at which they would advise vaccination of pregnant women and how often they would consider it appropriate to vaccinate. Of the respondents, 187 had provided prenatal care within the past year.
Of those, 88.5% said they regularly recommended that healthy pregnant women be vaccinated for influenza. These recommendation habits did not differ significantly across specialties, practice locations, number of doctors in a practice, gender of provider or number of years in practice.
Multivariable regression analysis revealed a significant association between routine vaccine recommendation and younger physician age (adjusted OR=2.01; 95% CI, 1.29-3.13) and higher weekly volume of pregnant patients (adjusted OR=1.95, 95% CI, 1.25-3.06). A lower percentage of obstetricians in rural settings (90.3%) reported having storage units appropriate for vaccines than did rural family physicians (98.5%; P=.001). The majority of the prenatal care providers reported that they understood the value of influenza vaccination in pregnant women.
According to the researchers, these findings suggest that determining and addressing barriers to vaccination at the patient level will be necessary to increase vaccine coverage in pregnant women.
“There is a discrepancy between recommendations as reported by providers and the number of maternal immunizations as reported by pregnant women,” the researchers wrote. “This study suggests that future increases in influenza vaccine among pregnant women may be more influenced by patient education than increased physician knowledge.”
Disclosure: The researchers report no relevant financial disclosures.
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