A closer look at unvaccinated pregnant women: Knowledge, attitudes, and beliefs about influenza vaccination, United States, 2012-13 influenza season

Background: Pregnant women and their newborns are at risk for influenza-associated complications; however, only 47% of pregnant women were vaccinated against influenza early in the 2012-13 season (opt-in panel survey). Provider recommendation for influenza vaccination increases vaccination. We examined demographic characteristics and knowledge, attitudes, and beliefs (KABs) of women who received provider recommendation to understand factors associated with vaccination. Methods: Data from a November 2012 national internet-panel survey of women currently pregnant or pregnant since the beginning of the influenza season were used to assess self-reported vaccination status, provider vaccination recommendation, and KABs. The sample was weighted to reflect the population of U.S. pregnant women. Of eligible women starting the survey, 2,072 completed it (94.5%). Among women reporting provider recommendation, we compared vaccinated (n=829) and unvaccinated (n=462) using weighted analysis. Results: Overall, 65.3% reported provider vaccination recommendation and 34.7% of these women remained unvaccinated. Compared to their vaccinated peers, unvaccinated women were less likely to have a college degree (51.3% vs.62.1%); less likely to agree that vaccination would protect their baby from flu after birth (33.9% vs. 71.1%); less likely to believe vaccine was effective (49.4% vs. 89.7%); and less likely to believe vaccination was safe for mother (50.6% vs. 91.6%) and baby (45.1% vs. 88.0%). Conclusions: Provider recommendation does not guarantee influenza vaccination for pregnant women. Tools and talking points for providers should focus on the real risks of influenza for pregnant women and their babies and the safety and efficacy of influenza vaccination to prevent these risks.