Factors associated with a successful expansion of influenza vaccination among pregnant women in Nicaragua

Arriola, Carmen Sofia; Vasconez, Nancy; Thompson, Mark G.; Mirza, Sara; Moen, Ann; Bresee, Joseph S.; Talavera, Ivy; Ropero, Alba María

doi:10.1016/j.vaccine.2015.12.065

Cited by 19 publications

(32 citation statements)

References 31 publications

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“…Overall, we observed a high acceptance of influenza vaccination among pregnant women in Managua, just as we did in our survey in 2013 [2]. Specifically, of the 40% that received a recommendation and an offer of influenza vaccination, 95% were vaccinated; however, among those who received neither a vaccination recommendation nor an offer, only 5% were vaccinated.…”

Section: Discussionsupporting

confidence: 73%

“…From 2007 to 2012, the Government of Nicaragua offered influenza vaccination to at-risk groups including pregnant women with obstetric risks. In 2013, Nicaragua expanded influenza vaccination to all pregnant women in the municipality of Managua [2], and since 2014, influenza vaccination was included in the annual vaccination campaign for all pregnant women nationwide. Antenatal care in Nicaragua is carried out at primary healthcare facilities; however, pregnant women diagnosed with high-risk obstetric conditions (HROC) may be referred to a tertiary hospital.…”

Section: Introductionmentioning

confidence: 99%

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Knowledge, attitudes and practices about influenza vaccination among pregnant women and healthcare providers serving pregnant women in Managua, Nicaragua

Arriola

Vasconez²,

Bresee

et al. 2018

Vaccine

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Background Nicaragua implemented an influenza vaccination program for pregnant women with high-risk obstetric conditions in 2007. In 2014, the recommendation of influenza vaccination expanded to include all pregnant women. Given the expansion in the recommendation of vaccination, we evaluated knowledge, attitudes and practices of pregnant women and their healthcare providers towards influenza vaccination and its recommendation. Methods We conducted surveys among pregnant women and their healthcare providers from June to August 2016 at two hospitals and 140 health facilities in Managua. The questions were adapted from the U.S. national CDC influenza survey and related to knowledge, attitudes and practices about influenza vaccination and barriers to vaccination. We analyzed reasons for not receiving vaccination among pregnant women as well as receipt of vaccination recommendation and offer by their healthcare providers. Results Of 1,303 pregnant women enrolled, 42% (5 4 5) reported receiving influenza vaccination in the 2016 season. Of those who reported not receiving vaccination, 46% indicated barriers to vaccination. Pregnant women who were vaccinated were more likely to be aware of the recommendation for vaccination and the risks of influenza illness during pregnancy and to perceive the vaccine as safe and effective, compared to unvaccinated pregnant women (p-values < 0.001). Of the 619 health workers enrolled, over 89% recalled recommending influenza vaccination to all pregnant women, regardless of obstetric risk. Of the 1,223 women who had a prenatal visit between the start date of the influenza vaccination and the time of interview, 44% recalled receiving a recommendation for influenza vaccination and 43% were offered vaccination. Vaccination rates were higher for those receiving a recommendation and offer of vaccination compared with those who received neither (95% vs 5%, p-value < 0.001). Conclusion Pregnant women in Managua had positive perceptions of influenza vaccine and were receptive to receiving influenza vaccination, especially after the offer and recommendation by their healthcare providers.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes and practices about influenza vaccination among pregnant women and healthcare providers serving pregnant women in Managua, Nicaragua

Arriola

Vasconez²,

Bresee

et al. 2018

Vaccine

Self Cite

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“…The Region of the Americas has been a leader in MNI, with years of programmatic experience in vaccinating pregnant women against tetanus, diphtheria, and influenza (10 – 12). In April 2015, the Region of the Americas was declared free of rubella endemic transmission and congenital rubella syndrome, diseases that had affected nearly 20 000 infants annually (13, 14).…”

Section: Ratonale For Maternal and Neonatal Immunizationmentioning

confidence: 99%

“…The maternal and neonatal immunization platform is a very promising approach for reducing morbidity and mortality associated with vaccine-preventable diseases among this important population group. Building on significant programmatic experience with vaccination, the countries of the Americas have successfully introduced and sustained maternal and neonatal vaccines—Td, Tdap, and influenza for pregnant women, and BCG and hepatitis B for newborns (10, 11). These introductions have been facilitated by various factors, including alliances with relevant scientific societies, the population’s trust in national immunization programs, and effective social communication.…”

Section: Other Considerations For Successmentioning

confidence: 99%

Progress towards a comprehensive approach to maternal and neonatal immunization in the Americas

Álvarez

Jaúregui

Omeiri

2017

Revista Panamericana De Salud Pública

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Maternal and neonatal immunization (MNI) is a core component of the new immunization model in the Americas, which transitioned from immunization of children to that of the entire family. Immunization during pregnancy protects the mother and the fetus by providing the neonate with maternal antibodies against disease. It has the potential to impact early childhood morbidity and mortality, and thus MNI has gained visibility and priority on the global health agenda. The Region of the Americas is a leader in MNI, as seen by its elimination of congenital rubella syndrome in 2015 and the progress made toward neonatal tetanus elimination. In the Americas, 31 countries currently target pregnant women for influenza vaccination; and 21 countries—over 90% of the Region’s birth cohort—have nationwide newborn hepatitis B vaccination. This paper describes the status of MNI in the Americas and identifies gaps in the evidence, obstacles to optimal implementation, and opportunities for future improvements. Catalysts for MNI in the Region have been political commitment, endorsement by scientific societies, an established “culture of vaccination,” widespread access to antenatal care, and context-specific communications; however, universal and equitable access for pregnant women and their newborns continues to be a formidable challenge, and additional vaccine safety and effectiveness evidence is needed. Continued efforts to integrate MNI with maternal and child health services will be critical to furthering the MNI platform as well.

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“…Many studies have tried to determine the factors in uencing coverage of vaccination against in uenza during pregnancy. Different authors have highlighted that vaccination recommendation by health professionals is the main reason why pregnant women chose to be vaccinated against in uenza [16][17][18][19][20]. Other studies have identi ed additional in uences such as: socio-economic characteristics, fear of side effects, doubts about the safety and effectiveness of the vaccine, fear of needles/pain or under-estimation of personal risk [21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes and practices on influenza vaccine during pregnancy in Quito, Ecuador

Erazo

Grijalva

et al. 2020

Preprint

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Background: Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses in pregnant women and their children. In Ecuador, the coverage of seasonal influenza vaccination in pregnant women is low. The aim of this study was to assess the knowledge, attitudes and practices of pregnant women toward influenza vaccination in Quito-Ecuador.Methods: A cross-sectional study enrolled 842 women who delivered at three main public gynecological-obstetric units of the Metropolitan District of Quito. A questionnaire regarding demographics, antenatal care, risk conditions and knowledge, attitudes and practices related to influenza vaccination was administered. We examined factors associated with vaccination using log-binomial regression models.Results: A low vaccination rate (36.6%) against influenza was observed among pregnant women. The factors associated with vaccination included the recommendations from health providers (adjusted PR: 15.84; CI 95% 9.62-26.10), belief in the safety of the influenza vaccine (adjusted PR: 1.53; CI 95% 1.03-2.37) and antenatal care (adjusted PR: 1.21; CI 95% 1.01-1.47). The most common reasons for not vaccinating included the lack of recommendation from health care providers (73.9%) and lack of access to vaccine (9.0%).Conclusions: Health educational programs aimed to pregnant women and antenatal care providers have the most potential to increase influenza vaccination rates. Further studies are needed to understand the barriers of health care providers regarding influenza vaccination in Ecuador.

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Factors associated with a successful expansion of influenza vaccination among pregnant women in Nicaragua

Cited by 19 publications

References 31 publications

Knowledge, attitudes and practices about influenza vaccination among pregnant women and healthcare providers serving pregnant women in Managua, Nicaragua

Knowledge, attitudes and practices about influenza vaccination among pregnant women and healthcare providers serving pregnant women in Managua, Nicaragua

Progress towards a comprehensive approach to maternal and neonatal immunization in the Americas

Knowledge, attitudes and practices on influenza vaccine during pregnancy in Quito, Ecuador

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