Influenza Vaccination among Pregnant Women in Mississippi, Pregnancy Risk Assessment Monitoring System (PRAMS), 2009-2011

BACKGROUND: During influenza season, pregnant women are of special interest due to adverse maternal and infant outcomes resulting from infection. 

OBJECTIVE: Examine the association between influenza vaccination among pregnant women and discussions with healthcare providers.

METHODS: The 2009 – 2011 PRAMS survey flu supplement was used (n=2195). The outcome of interest was vaccination status (seasonal influenza / H1N1) and the exposure of interest was healthcare discussions about vaccination. These factors were examined by race, age, BMI, educational level, prenatal care (PNC) initiation, and Medicaid status. Descriptive statistics and chi-square analyses were run using SAS 9.3.

RESULTS: The population was 53% White, 46% Black, most (94%) were < 35 yrs, and many (79%) completed high school education or higher. Approximately one fifth (n=487) had PNC Medicaid,  78% (n=1702) had 1st trimester PNC, and 60%  (n=1255) were offered influenza/H1N1 shots. Twenty percent (n=376) received both shots; 6% (n=141) received seasonal only, 21% (n=445) received H1N1 only, and 53% (n=1171) received neither. Results showed significant differences in vaccination offers by age (p= <.0001), education (p= <.0001) and Medicaid PNC status (p= 0.002). There were significant differences in vaccination status by healthcare discussions (p= <.0001), race (p= 0.001), BMI (p= 0.014), education (p= <.0001), PNC initiation (p= <.0001).

CONCLUSIONS: Influenza vaccination was significantly associated with healthcare provider discussions and other maternal characteristics and behaviors. This relationship should be studied further with advanced analyses.

PUBLIC HEALTH IMPLICATIONS: Vaccination coverage of pregnant women can be improved by studying the relationship between providers’ health promotion and women’s actions.