Predictors of H1N1 Influenza Vaccine Uptake Among Pregnant Women in Hong Kong

Pregnant women who contract influenza are at a greater risk of being hospitalized and of pregnancy complications such as pre-term labor, fetal distress, and cesarean section. Consequently, pregnant women are a priority group to receive annual influenza vaccination. During the 2009 H1N1 influenza pandemic, pregnant women who contracted influenza experienced excess morbidity and mortality when compared with similar aged women. The aim of this study is to assess the predictors of influenza vaccine uptake among pregnant women in Hong Kong during the H1N1 influenza pandemic and to identify predictors of uptake. We used a multi-centre, cross-sectional design and recruited 549 post-partum mothers who were pregnant during the 2009-10 influenza season from the post-natal obstetric units of four public hospitals in Hong Kong. Participants completed a self-administered questionnaire that assessed vaccination status and factors related to vaccination uptake. Only 6.2% of pregnant women had received the H1N1 vaccine. The major reasons for not receiving the vaccine were fear of side effects for self or the baby. Having a family member who was infected with H1N1 or who had received the vaccine were both strongly associated with being vaccinated. Additionally, women with higher knowledge levels and more positive attitudes toward vaccination were more likely to be vaccinated. Influenza vaccination rates in pregnant women are often sub-optimal. In order to increase uptake of vaccination, promotion efforts should focus on dispelling misperceptions about vaccine side effects and increasing knowledge and attitudes among pregnant women.