Influenza Vaccination Coverage among Pregnant Women: Results from the Pregnancy Risk Assessment Monitoring System (PRAMS), Rhode Island, 2005-2007

Background:
Pregnant women are at risk for influenza complications. In 2004, the Advisory Committee on Immunization Practices (ACIP) published new recommendations that all pregnant women or women who will be pregnant during influenza season should be vaccinated.

Objectives:
1) determine the proportion of health care providers who recommended, and the proportion of women who received, influenza vaccination during pregnancy, and 2) assess the association between health care provider recommendation and receipt of influenza vaccination among pregnant women.

Methods:
Rhode Island added the following two influenza immunization questions to the PRAMS survey to monitor influenza vaccination among pregnant women: “At any time during your most recent pregnancy, did a doctor, nurse, or other health care worker offer you a flu vaccination or tell you to get one?” and “Did you get a flu vaccination during your most recent pregnancy?”

Results:
The analysis of the 2005-2007 data (n=approximately 1,400 each year) revealed little change in the proportion of women who were recommended by health care providers to receive influenza vaccination during their pregnancy; 46.6% in 2005, 45.5% in 2006 and 47.7% in 2007 (p= 0.6358; 3-year average=46.6%). There was no significant change in the proportion of pregnant women who got influenza vaccination; 30.1% in 2005, 30.4% in 2006 and 33.4% in 2007 (p=0.2454; 3-year average=31.3%). Three-year combined data showed that 63% of pregnant women received influenza vaccination when their health care provider recommended it, while only 4% of the pregnant women received influenza vaccination when their health care provider did not recommend one (p=0.0000).

Conclusions:
Less than one half of health care providers recommended influenza vaccination to pregnant women, and less than one third of pregnant women received influenza vaccination during 2005-2007. The data indicate that health care provider recommendations play an important role in the acceptance of influenza vaccination among pregnant women.