| Summary: | Despite the World Health Organization identifying pregnant women as the highest priority group for seasonal influenza vaccination, many pregnant women remain unaware of the recommendation and have substantial concerns about the adverse effects of the vaccine on them and their unborn foetuses. Few interventions have been conducted to improve influenza vaccine uptake among pregnant women. Among these studies, the results are inconsistent and the quality is generally low. Brief education has been previously shown to improve women’s health practices during pregnancy.
An open-label randomized control trial was conducted to assess the effect of providing brief education on influenza vaccine uptake among pregnant women. A total of 163 unvaccinated pregnant women in at least their second trimester were recruited from antenatal clinics of four public hospitals in Hong Kong. They were randomized to receive standard care or a one-to-one brief education session that provided an overview of the safety and benefits of the vaccine to both pregnant women and their foetuses. Participants were followed up by telephone at two to three weeks postpartum to ascertain vaccination status. The primary study outcome was the influenza vaccine uptake rate and the second study outcomes were the proportion of participants initiating discussion about influenza vaccine with their health care providers, the proportion attempting to be vaccinated, and their knowledge of influenza infection and vaccination.
A total of 163 participants were recruited with 155 (95%) participants completing follow-up. The overall influenza vaccine uptake rate was 17.8%. When compared with those receiving standard care, the vaccination rate was higher among participants who received the intervention (23.5% vs. 12.2%; p=0.06). In addition, the increase in the rate of self-initiated discussion with HCPs before and after the intervention was significantly higher in intervention group (26.7% vs. 9.3%; p<0.001) but not in standard care group (13.3% vs. 8%; p=0.481). Among participants who did not receive influenza vaccine, pregnant women in intervention group were substantially more likely to have made an unsuccessful attempt to be vaccinated (39.3% vs. 9.2%; p<0.001). Almost one-third of the pregnant women who had attempted to receive the vaccine (n=13) reported they received advice against vaccination during pregnancy from HCPs. If participants had not been advised against influenza vaccine and were successfully vaccinated, the overall difference in the vaccine uptake rate between the two treatment groups would have been statistically significant (34.6% vs. 18.3%; p=0.02).
Brief education can be one strategy to improve vaccination uptake rates among pregnant women. In addition, it is clear from this and other studies that recommendations from HCPs substantially influence vaccination behaviours among pregnant women, both positively and negatively. Therefore, multicomponent approaches should be considered in future vaccination programmes and the synergistic effect of both brief education and HCP recommendations should be further evaluated. === published_or_final_version === Nursing Studies === Master === Master of Philosophy
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