Knowledge and Attitudes of Pregnant Women Towards Recommendations for Immunization During Pregnancy
Methods: Prospective, convenience survey of pregnant women presenting for routine, antenatal care at the Pavilion for Women, Texas Children’s Hospital, Houston.
Results: 796 of 825 (96.5%) of women invited to participate completed surveys. The mean age of participants was 30.2 (range 18-45) years. Self-identified race/ethnicity was 45% white, 26% Hispanic, 13% black, 12% Asian and 4% mixed or other. Most women had college degrees (84%) and private health insurance (83%); 17% had pre-conception doctor visits. The mean gestation at participation was 28.5 (range 3-41.8) weeks with 4.8%, 37.8% and 57.4%, in the 1st, 2nd and 3rd trimesters, respectively. Women used a number of sources for pregnancy information (personal contacts, healthcare providers [HCP], print, audiovisual and online media) but 89.1% cited a HCP as the most trusted source, and for 85.8% it was their physician. Most avoided smoking, alcohol (99% each) and certain foods (78.2%) for fetal health; 92.6% intended to breastfeed. 668 (84%) knew that vaccines can be given during pregnancy. 77% and 61% knew that influenza and Tdap, respectively, were recommended. 659 (83%) were willing to receive vaccines during pregnancy if recommended by their doctor. Factors impacting the decision to be vaccinated included safety for baby, safety for mother and being sufficiently informed, scoring 4.7, 4.5 and 4.2, respectively, on a 5-point scale. Factors considered less important were extra time taken (2.6), cost (1.9) or fear of needles (1). Women in the 3rd trimester were more accepting of vaccines than those earlier in gestation (87% vs 78%; P= 0.003). Serious illness in a prior infant or current multiple gestation did not affect willingness to receive vaccines.
Conclusion: Pregnant women are willing to accept vaccines in pregnancy if recommended by their physician and if sufficient discussion of safety and rationale occurs. Strong healthcare provider recommendation, as is proven for pediatric vaccination, is essential to optimizing uptake of vaccines during pregnancy.
C. M. Healy,
Sanofi Pasteur: Grant Investigator, Research grant
Novartis: Grant Investigator and Scientific Advisor, Consulting fee and Research grant
M. Gandhi, None
C. Perez, None
L. Swaim, None