Vacinação contra o vírus influenza em gestantes: cobertura da vacinação e fatores associados

Abstract

Objectives:To describe the immunization coverage of the influenza vaccine for pregnant women, and factors associated to vaccination compliance.Methods:This is a prospective, descriptive study including 300 women who had just given birth at Hospital and Maternity Santa Joana in Sao Paulo, Brazil. Data were collected through a pre-tested questionnaire applied by a trained evaluator during October 2010.Results:The mean age of mothers was 30.5 years; 231 (77%) were married; 164 (54.7%) were primigravidas; 192 (64%) had higher education; and 240 (80%) were employed. During the prenatal period, 234 (78%) received information about the influenza vaccine and 287 (95.7%) were immunized; 210 (73.2%) women knew about neonatal protection achieved through maternal vaccination. The factors associated with maternal acceptance of the vaccine were government campaign (133; 44.3%), and medical recommendation during prenatal visits (163; 54.3%). A total of 13 pregnant women refused vaccination for the following reasons: neglect (4), lack of time (4), lack of recommendation from their physician (3) or contraindication by physician (2), but 69.2% of them would have accepted immunization had they been informed about neonatal protection.Conclusions:The fear of a pandemic and the public vaccination campaign had an important impact on the high immunization coverage for influenza on pregnant women. Medical recommendation and the government campaign were the main reasons for vaccine compliance.

Qualidade da assistência pré-natal nos serviços públicos e privados

“…Com relação à vacinação contra influenza, o dobro da frequência de vacinação contra influenza do serviço privado (16,1%) em relação ao público (8,8%) verificado neste estudo, poder estar relacionado ao período de maior disponibilidade no privado em relação ao período de campanhas no público. Entretanto, a imunização no município deste estudo foi inferior aos 95,7% das gestantes imunizadas contra influenza durante o pré-natal num serviço privado do estado de São Paulo 19 . Já se verificou que o conhecimento da proteção neonatal, o empenho de campanhas do governo e a recomendação médica auxiliam na cobertura da vacinação contra influenza 19 .…”

“…Entretanto, a imunização no município deste estudo foi inferior aos 95,7% das gestantes imunizadas contra influenza durante o pré-natal num serviço privado do estado de São Paulo 19 . Já se verificou que o conhecimento da proteção neonatal, o empenho de campanhas do governo e a recomendação médica auxiliam na cobertura da vacinação contra influenza 19 .…”

Uptake of influenza vaccination in pregnancy amongst Australian Aboriginal and Torres Strait Islander women: a mixed-methods pilot study

“…Our findings with respect to low uptake of influenza vaccination in pregnancy are similar to studies conducted in other populations, albeit with coverage ranging from 10 to 60% [ 23 - 27 ]. Studies that have investigated differences in uptake within populations have reported lower uptake in minority groups (eg non-Hispanic African Americans compared to non-Hispanic Americans in the United States) and between socio-economic groups [ 24 , 28 - 31 ]. Potential explanations for these disparities include access to health services, cost of vaccine and the logistics of being vaccinated and the lack of socio-culturally appropriate education.…”

Social and obstetric inequalities and vaccination in pregnant women

“…In low and middle-income countries, low proportions of immunization predominated in poorer families and children of mothers with low levels of education (11,18) , especially due to unequal access to health services generated by social stratification (12,19). In Brazil, socioeconomic status and access to health services have proven to be determinant factors for higher vaccination coverage in the gestational period (20)(21)(22) .…”

“…The hypothesis of this study is that social inequalities determine low coverage of access to health services and, specifically, standardized interventions or actions, such as vaccination in pregnant women. To our knowledge, there are few recent studies that show the increased vaccine coverage associated with factors such as: vaccine acceptability, access to information, socioeconomic status, and education (12,(22)(23) . Other studies found no association between socio-demographic factors (age, skin color, marital status, education, among others) and higher percentage of vaccination (1,24) .…”