Knowledge and Attitudes about the Flu Vaccine among Pregnant Women in the Valencian Community (Spain)

Abstract

Background and Objectives: To describe the knowledge and attitudes related to the acceptance of the flu vaccine during pregnancy in women, from two Health Departments of the Valencian Community (VC), during the 2015–2016 season, after receiving prenatal care. Materials and Methods: A prospective observational study was conducted during the annual vaccine season of women ascribed to prenatal care. A midwife offered flu vaccine advice and afterwards conducted a telephone poll of a representative sample, in order to find out the reason for accepting or rejecting the vaccine. Results: Of the 1017 expectant women who received advice about the vaccine, 77.4% (95% CI: 74.8–79.9%) declared their intention to vaccinate. After the recommendation, the vaccine coverage was 61.6%, with a percentage of accordance of 98.8% (95% CI: 98.0–99.6%) between the coverage declared and the Nominal Vaccination Registry (NVR) of the VC. Additionally, 67.2% of the expectant women were interviewed (n = 683). Most were aware of the recommendation and identified the health center and the midwife as the main sources of information. The internet was a consistent source in favor of vaccination 80.8% (n = 42). The obstetric variables (risk during the pregnancy, end of pregnancy, and feeding the newborn) did not have a statistically significant relationship with the vaccination. The women declared a high adherence to the vaccinations present in the child vaccination calendar, but rejected (31.3%) the flu vaccine, as they had not received it previously and did not want it because of their expectant state. Conclusions: The women positively evaluated the effectiveness and safety of the vaccines. However, with the flu vaccine, “not being previously vaccinated” and the “doubts about its safety” represented more than half of the reasons put forth for its rejection. Ensuring that the flu vaccine is perceived as more effective and acceptable through the messages directed towards the expectant mothers, directly through the midwives or through the communication media and social networks, will result in an increase of vaccine coverage.

Influenza Vaccination Experiences of Pregnant Women as a Predictor of the Intention to Become Vaccinated in Future Pregnancies in Spain

“…As for the flu vaccine, we received responses such as “it is not an effective or necessary vaccine” and “I have doubts or mistrust about its safety”, which represented more than half of the reasons provided for rejecting it in future occasions [ 27 , 32 , 42 ]. Pregnant women differ from those who are not, because they have concerns about the safety of vaccines for the fetus, and some prefer not to become vaccinated during pregnancy [ 11 ]. Key aspects for improving the low flu vaccine coverage of the pregnant women include knowing the reasons provided by the women who rejected the vaccine, having health professionals who are trained to provide answers to their doubts, provide more opportunities for vaccination and include prenatal vaccine recommendations, creating a vaccine history for every woman [ 32 ].…”

“…Faced with the new option of adding new vaccines during pregnancy, it is interesting to know and assess the experiences of women after receiving vaccines and how they perceived the repercussions on their health and the child’s as well [ 4 ]. A key element for the success of a vaccination program is transmitting the future mothers a good opinion about the safety and efficiency of the vaccines, which are the most influential factors when deciding to vaccinate or not [ 11 ]. Fortunately, the vaccines recommended against influenza and whooping cough have a good safety profile [ 2 , 12 ].…”

“…Previous research studies have evaluated the barriers or reasons for not being vaccinated against influenza [ 20 , 21 ], but not many studies have been found that aimed at assessing the intention of the pregnant women to become vaccinated in the future after their previous experience with the influenza vaccine or having suffered from the illness [ 4 ]. Different studies have observed that the advice and recommendations provided by a health professional during pregnancy are key for achieving a good vaccination coverage [ 4 , 11 ].…”

Safety of anti-influenza vaccination during pregnancy

“…Table 1. Distribution of frequencies and percentages in women surveyed on the knowledge and sources of information about flu vaccine [10].…”

“…The main reason that pregnant women refused the flu vaccine was fear of advert effects and not being previously vaccinated, which accounts for more than half of the reasons put forth for its rejection. [10] Figure 1. Reasons provided for not vaccinating [10].…”