A Comprehensive Review of Influenza and Influenza Vaccination During Pregnancy

Abstract

Influenza is a highly infectious respiratory disease that can impose significant health risks leading to increased morbidity and mortality. Receiving influenza vaccination is the most important and effective means of preventing the infection and its related complications. During pregnancy, physiological changes increase susceptibility to influenza infection, and women contracting infectious diseases during pregnancy are more likely to have adverse pregnancy and neonatal outcomes. Influenza vaccination during pregnancy is safe for both pregnant women and their fetus, and pregnant women are now the highest priority group for vaccination. Despite the accumulated evidence of the benefits and safety of influenza vaccination during pregnancy, uptake among pregnant women remains suboptimal. Concerns about the vaccine's safety persist, and the fear of birth defects remains the predominant barrier to vaccination. Targeted interventions have been shown effective in enhancing influenza vaccination uptake among pregnant women. Reluctance to be vaccinated should be addressed by offering accurate information to counteract the misperceptions about the risk of influenza infection during pregnancy as well as to educate mothers about the safety and benefits of influenza vaccination. High-quality randomized controlled trials are recommended to evaluate the effectiveness of individual or multifaceted approaches to increase vaccine uptake.

Determinants of seasonal influenza vaccination in pregnant women in Valencia, Spain

“…In short, our results consistently confirm those obtained by other groups [1, 27, 35], where more than half of vaccination rejections stemmed from a perceived lack of data on the efficacy and safety of vaccine. Due to the determinant influence of these perceptions and beliefs, it is essential to carry out qualitative studies that would inform and facilitate improvement interventions.…”

“…Pregnancy is an independent risk factor for developing severe seasonal influenza [1]. Many international organizations recommend the administration of influenza vaccine to pregnant women [2, 3] since influenza infection is associated with higher maternal morbidity and mortality, increased hospital admissions and worse perinatal outcomes [4, 5].…”

“…Different authors [1, 9] have highlighted that vaccination recommendation by health professionals is the main reason why women choose to be vaccinated against influenza. However, lack of information by health professionals also remains a frequently cited determining factor for rejecting vaccination [10].…”

Do Thai Physicians Recommend Seasonal Influenza Vaccines to Pregnant Women? A Cross-Sectional Survey of Physicians’ Perspectives and Practices in Thailand

“…Vaccination is regarded as the most effective influenza preventive strategy [7,8] and has been documented to be both safe and effective for preventing influenza in pregnant women [9,10]. In addition, some studies indicate that vaccination of pregnant women may provide protection against influenza to infants during the first few months of life, before they are eligible for vaccination [10–12].…”

Influenza infections in the 2014–2015 season and pregnancy outcomes

“…The increased vulnerability of pregnant women can be attributed to physiologic changes of the respiratory and immunological systems during pregnancy. These changes include an altered form of the thoracic space, dyspnea, increased oxygen consumption and tidal volume, decreased functional residual capacity, decreased cellular immunity that is crucial for the survival of the fetus, and increased vulnerability to all respiratory pathogens, including influenza [9,10]. In seriously ill pregnant women, symptoms related to viral upper-airway infections (fever, cough, sore throat, and myalgia) may be exaggerated, and a fever of >39 °C and decreased arterial oxygen saturation may be present.…”