Review of the status and challenges associated with increasing influenza vaccination coverage among pregnant women in China

Zhou, Suizan; Greene, Carolyn M.; Song, Ying; Zhang, Ran; Rodewald, Lance; Feng, Luzhao; Millman, Alexander J.

doi:10.1080/21645515.2019.1664230

Cited by 7 publications

(6 citation statements)

References 85 publications

(107 reference statements)

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“…The IVC among pregnant women slightly increased in France after the 2012 WHO recommendation, from 0.33 to 1.79% (p < 0.001) but even in later times, it is still very low (4.1% in 2018) [ 2 ]. The estimated IVC among pregnant women in China in 2004–2014 was < 1.5%, which is consistent with other published Chinese regional estimates [ 21 ].…”

Section: Discussionsupporting

confidence: 89%

Vaccination against influenza in pregnant women in a maternity hospital in the Czech Republic in the season 2020–2021

et al. 2023

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Objectives Pregnant women are among the priority groups to receive influenza vaccines in the Czech Republic since 2011, data on vaccination coverage are not yet available. The aim of the study was to determine the influenza vaccination coverage (IVC) and provide source data for further activities. Methods A prospective observational study was performed in a large maternity hospital in Prague. The self-completed questionnaire was distributed to 5,475 pregnant women between September 1, 2020 and August 31, 2021. Questions included maternal sociodemographic characteristics, influenza vaccination status and sources of maternal vaccination recommendations during pregnancy. Results A total of 4,617 completed questionnaires have been analysed. The median age of study participants (N = 4,592) was 33 years (range: 18–51 years). The majority (69.7%) of women had completed their university education, most women were childless (58.5%) or had one child (32.5%) before the start of the study. Less than 2% of women reported being vaccinated against influenza during their pregnancy (1.5%; 95% CI, 1.1–1.9%). Only 21% of women knew that it’s possible to get vaccinated against influenza during pregnancy. Participants considered influenza vaccination in pregnancy as important (3.3%), useful (41.1%) and useless (44.4%). Out of 959 pregnant women who had information about influenza vaccination during pregnancy, only 6.9% were vaccinated, while among those who did not have this information, 0.1% were vaccinated during pregnancy (p < 0.001). The most frequent source of information was Internet, then media and a general practitioner. Conclusions The IVC during pregnancy in our study was extremely low. In order to improve IVC among pregnant women, it is necessary to increase awareness of recommendations and vaccination options among the public and professionals and incorporating vaccination recommendation in routine antenatal practice.

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Section: Discussionsupporting

confidence: 89%

Vaccination against influenza in pregnant women in a maternity hospital in the Czech Republic in the season 2020–2021

et al. 2023

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“…Pregnant woman in China are not getting vaccinated for seasonal influenza, and other studies have shown that barriers to vaccination include pregnancy listed as a contraindication in package insert, self‐perceptions that they are not at risk of infection and healthcare worker reluctance to vaccinating this population. 16 These data can support risk communication and may help promote effective prevention and control measures for influenza including vaccination during pregnancy.…”

Section: Discussionmentioning

confidence: 93%

“…In China, there are significant barriers to promoting seasonal influenza vaccination in pregnant women including an absolute contraindication for this population in the Chinese Pharmacopeia until the latest revision in 2020, healthcare worker reluctance to recommend this vaccination to pregnant women, and women's concerns about vaccine safety or lack of awareness of vaccination. 13 , 14 , 15 , 16 Knowledge of influenza infection during pregnancy is also limited. Previous studies found that only 20% of surveyed pregnant women were aware that influenza infection could cause serious harm during pregnancy and 61% reported an interest in learning about prevention and control of influenza.…”

Section: Introductionmentioning

confidence: 99%

“…12 In China, there are significant barriers to promoting seasonal influenza vaccination in pregnant women including an absolute contraindication for this population in the Chinese Pharmacopeia until the latest revision in 2020, healthcare worker reluctance to recommend this vaccination to pregnant women, and women's concerns about vaccine safety or lack of awareness of vaccination. [13][14][15][16] Knowledge of influenza infection during pregnancy is also limited.…”

Section: Introductionmentioning

confidence: 99%

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Incidence rates of influenza illness during pregnancy in Suzhou, China, 2015–2018

Chen¹,

Zhou

Lin³

et al. 2021

Influenza Resp Viruses

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Background: Data on influenza incidence during pregnancy in China are limited.Methods: From October 2015 to September 2018, we conducted active surveillance for acute respiratory illness (ARI) among women during pregnancy. Nurses conducted twice weekly phone and text message follow-up upon enrollment until delivery to identify new episodes of ARI. Nasal and throat swabs were collected ≤10 days from illness onset to detect influenza.Results: In total, we enrolled 18 724 pregnant women median aged 28 years old, 37% in first trimester, 48% in second trimester, and 15% in third trimester, with seven self-reported influenza vaccination during pregnancy. In the 18-week epidemic period during October 2015 to September 2016, influenza incidence was 0.7/100 person-months (95% CI: 0.5-0.9). In the cumulative 29-week-long epidemic during October 2016 to September 2017, influenza incidence was 1.0/100 person-months (95% CI: 0.8-1.2). In the 11-week epidemic period during October 2017 to September 2018, influenza incidence was 2.1/100 person-months (95% CI: 1.9-2.4).Influenza incidence was similar by trimester. More than half of the total influenza illnesses had no elevated temperature and cough. Most influenza-associated ARIs were mild, and <5.1% required hospitalization.Conclusions: Influenza illness in all trimesters of pregnancy was common. These data may help inform decisions regarding the use of influenza vaccine to prevent influenza during pregnancy.

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“…Although in uenza vaccination uptake in pregnant women differs across regions (US: 20%; Asia: 9.4-37.8%; South America: 3-97%; Australia 27%) [54][55][56][57], the reasons for vaccine uptake seem similar: con dence in their safety and effectiveness [24] and risk-perceptions for diseases and vaccines [58] are globally important. Most of the studies, worldwide and in this review, found several reasons for vaccine hesitancy, but only a few used systematically validated multidimensional models such as the 5C model [22].…”

Section: Discussionmentioning

confidence: 99%

Determinants of Influenza Vaccine Hesitancy among Pregnant Women in Europe: A Systematic Review

Adeyanju

Engel

Koch

et al. 2021

Preprint

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Background Pregnant women are at high risk for severe influenza, but maternal influenza vaccination uptake in most World Health Organization (WHO) European Region countries remains low, despite the presence of widespread national recommendations. An influenza vaccination reduces influenza-associated morbidity and mortality in pregnancy, as well as provides newborns with protection in their first months. Potential determinants of vaccine hesitancy need to be identified to develop strategies that can increase vaccine acceptance and uptake among pregnant women. The primary objective of the systematic review is to identify the individual determinants of influenza vaccine hesitancy among pregnant women in Europe and how to overcome the hesitancy. Methods Databases were searched for peer-reviewed qualitative and quantitative studies published between 2009 and 2019. These included PubMed via MEDLINE, Cochrane Central Register for Controlled Trials, PsycINFO, SAGE Journals, Taylor & Francis and Springer nature, covering the areas of psychology, medicine, and public health. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, 11 studies were eligible and analyzed for significant determinants of influenza vaccine hesitancy among pregnant women in Europe. Results The most reported factors were psychological aspects, for example concerns about safety and risks to mother and child, or general low risk perception of becoming ill from influenza. Doubts about the effectiveness of the vaccine and a lack of knowledge about this topic were further factors. There was also influence of contextual factors such as healthcare workers not providing adequate knowledge about the influenza vaccine or stating their anti-vaccine sentiment. Conclusion To overcome influenza vaccine hesitancy among pregnant women, it seems essential to increase the knowledge about influenza and the respective vaccination and to provide information for a valid risk judgment. The development of new information strategies for dialogue between healthcare providers and pregnant women should form part of this strategy.

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Review of the status and challenges associated with increasing influenza vaccination coverage among pregnant women in China

Cited by 7 publications

References 85 publications

Vaccination against influenza in pregnant women in a maternity hospital in the Czech Republic in the season 2020–2021

Vaccination against influenza in pregnant women in a maternity hospital in the Czech Republic in the season 2020–2021

Incidence rates of influenza illness during pregnancy in Suzhou, China, 2015–2018

Determinants of Influenza Vaccine Hesitancy among Pregnant Women in Europe: A Systematic Review

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