Influenza Vaccination Coverage Among Pregnant Women From the National 2009 H1N1 Flu Survey (NHFS), 2009-10 Influenza Season

Background:  Due to the increased risk of morbidity and death from influenza during pregnancy, the Advisory Committee on Immunization Practices (ACIP) and the American College of Obstetricians and Gynecologists (ACOG) recommend annual influenza vaccination for women pregnant during the influenza season.

Objectives: To describe influenza vaccination coverage for the 2009-10 influenza season among pregnant women in United States.

Methods:  We analyzed data from April-June 2010 interviews from the National 2009 H1N1 Flu Survey (NHFS), a random–digit-dialed telephone survey,  and compared influenza vaccination coverage among women 18-49 years pregnant during October 2009-January 2010 (influenza season), not pregnant but with high-risk conditions, and not pregnant without high-risk conditions. Univariate analysis used Wald chi-square tests followed by post-hoc pair-wise t-tests. Multivariable logistic regression was used to examine the association of pregnancy status with vaccination status controlling for demographic and belief variables in the model.

Results:  The Influenza A (H1N1) 2009 monovalent vaccination coverage for the 2009-10 influenza season among pregnant women was 45.7%, while among non-pregnant women with and without high-risk conditions it was 18.8% and 18.1%, respectively, p<0.05.  The 2009-10 trivalent seasonal vaccination coverage among the three groups was 32.1%, 30.5% and 24.0%, respectively. Receipt of a health care provider’s recommendation for vaccination, perceived effectiveness of influenza vaccines and perceived high chance of influenza infection were independently associated with higher 2009 H1N1 and seasonal vaccination coverage;  pregnancy  during the influenza  season was independently  associated with higher 2009 H1N1 vaccination coverage.

Conclusions:  The 2009 H1N1 vaccination level among pregnant women was higher than the seasonal vaccination level during the 2009-10 season; it was also higher than vaccination among non-pregnant women with and without high-risk conditions. Health care providers and public health communication should continue to emphasize positive vaccination behavior among pregnant women to prevent severe disease outcomes during the influenza season.