Determinants of 2009 A/H1N1 Influenza Vaccination Among Pregnant Women in Hong Kong

Abstract

During the 2009–2010 A/H1N1 influenza pandemic, pregnant women infected with the virus experienced excess morbidity and mortality when compared with other groups. Once a vaccine was available, pregnant women were a priority group for vaccination. Only a few studies have reported on the uptake of 2009 A/H1N1 influenza vaccine among pregnant women during the pandemic and none were from Asia. The purpose of this study was to examine factors associated with 2009 A/H1N1 influenza vaccine uptake among pregnant women in Hong Kong. Using a multi-center, cross-sectional design, we recruited 549 postpartum women from four post-natal wards in Hong Kong over a 4-month period during the second wave of the A/H1N1 influenza pandemic in the winter and spring of 2010. Only 6.2% (n = 34) of participants had received the 2009 A/H1N1 influenza vaccine and 4.9% (n = 27) had received the seasonal influenza vaccine. The most common reasons for not receiving the 2009 A/H1N1 vaccine were fear of causing harm to themselves or their fetus. A high knowledge level (OR = 19.06; 95% CI 5.55, 65.48), more positive attitudes (OR = 3.52; 95% CI 1.37, 9.07), and having a family member who had the 2009 A/H1N1 influenza vaccine (OR = 7.69; 95% CI 2.92, 20.19) were independently and positively associated with vaccination. Study results show an unacceptably low uptake of the pandemic A/H1N1 influenza vaccine among pregnant women in Hong Kong. Interventions to increase influenza vaccine knowledge and uptake among this group should be a priority for future pandemic planning and seasonal vaccination campaigns.

2010 A(H1N1) vaccination in pregnant women in Brazil: identifying coverage and associated factors

“…The 77% vaccination coverage observed in our study is higher than in other countries and is reliable based on official national figures 20 . Comparing to the results obtained in Brazil, the few studies performed in non-developed countries showed a very low coverage for H1N1 vaccination in pregnant women: 12.8% in India 21 , 8.9% in Turkey 18 and 6.2% in Hong Kong 22 . On the other hand, studies performed in developed countries showed better results than the former countries but still below the values reached in Brazil.…”

Prevalence and predictors of maternal seasonal influenza vaccination in Hong Kong

“…The 16-item scale was adapted by the authors [23] from a questionnaire originally developed by Tong et al [21] and was used with permission. The 16 scale items were based on the four primary components of the health belief model (HBM): perceived severity of influenza infection (3 items), perceived susceptibility to influenza infection (3 items), perceived benefits of influenza vaccination (4 items) and perceived barriers to receiving the influenza vaccine (6 items) [28].…”

“…Despite the accumulated evidence of the benefits of vaccination of pregnant women, seasonal influenza vaccine uptake rates are rarely higher than 50-60% [18][19][20] and are often less than 20% [21][22][23]. In Hong Kong, pregnant women are also identified as a target group for influenza vaccination.…”

“…Pregnant women must obtain the vaccine through their primary care practitioner or through a private clinic. Small-scale studies have reported uptake rates of less than 10% [23,24]. However, there has not been any population-based study in Hong Kong or in Asia to examine the uptake of seasonal influenza vaccine during pregnancy.…”

Effect of a hospital policy of not accepting free infant formula on in-hospital formula supplementation rates and breast-feeding duration

“…It is possible that breast-feeding practices may have improved naturally over this time period, independent of the policy change. However, breast-feeding data collected for another study (59) from the same hospitals with the same participant selection criteria, immediately prior to the policy implementation, show that there was no change in breast-feeding duration in the time interval between planned and actual policy implementation (see online supplementary material, Supplemental Fig. 1).…”