1642. Vaccine Refusal Among Pregnant Women: A National Survey of Obstetrician-Gynecologists
Session: Poster Abstract Session: Vaccine Hesitancy
Friday, October 6, 2017
Room: Poster Hall CD
Background: Little is known about vaccine refusal among pregnant women. Our objectives were to describe, among a nationally representative sample of obstetrician-gynecologists (ob-gyns): 1) perception of frequency of and reasons for vaccine refusal among pregnant women; and 2) strategies used to address vaccine refusal and perceived effectiveness of those strategies.

Methods: E-mail and mail survey among ob-gyns conducted 3-6/2016.

Results: The response rate was 69% (331/477). Pregnant women more commonly refused influenza (flu) vaccine compared to tetanus-diphtheria-acellular pertussis (Tdap) vaccine (Table 1).

Table 1. Percent of Pregnant Women Refusing Vaccines When Told They Need it*

None

1-9%

10-19%

20-29%

30% or more

Flu

1%

37%

33%

21%

8%

Tdap

9%

60%

20%

10%

2%

`

`

`

`

`

`

`

*Row % represents proportion of ob-gyns endorsing the response

The most common reasons reported as contributing to refusal of vaccines 'a lot' were belief that flu vaccine makes them sick (48%), belief that they are unlikely to get a vaccine-preventable disease (VPD) (38%), general worries about vaccines (32%), desire to maintain a 'natural' pregnancy (31%), and concern that their child could develop autism as a result of maternal vaccination (25%).

Physicians used several strategies to address refusal (Table 2). The strategy perceived as most effective was stating that not getting vaccinated puts the fetus/newborn at risk.

Table 2.#

Frequency of Use, %

Perceived Effectiveness, %

Always

Often

Sometimes

rarely/never

Very effective

Somewhat effective

Not very/not at all effective

State that you are confident that the vaccine is safe

74

22

4

19

61

21

Explain that not getting the vaccine puts her fetus/newborn's life at risk

58

33

10

40

51

9

Explain that not getting the vaccine puts her own health at risk

46

38

16

12

64

24

Discuss recent outbreaks of VPDs

39

33

29

19

52

30

Inform her that not getting the vaccine is against your recommendations

37

27

37

8

47

45

State that you would immunize yourself or your family member

21

32

47

19

61

20

#Statements pertain to generic vaccination.

Conclusion:  Ob-gyns perceive refusal of flu vaccine is more common among their pregnant patients than refusal of Tdap. Emphasizing the risk of disease to the fetus may be an effective strategy to increase uptake. It will be important to validate these findings in a patient sample.

Sean O'Leary, MD, MPH1, Laura Riley, MD2, Megan C. Lindley, MPH3, Mandy Allison, MD, MSPH4, Lori Crane, PhD, MPH5, Laura Hurley, MD, MPH6, Brenda Beaty, MSPH7, Michaela Brtnikova, PhD, MPH8, Alison Albert, MPH CHES9, Alison Fisher, MPH3, Angela Jiles, MPH9 and Allison Kempe, MD, MPH10, (1)Pediatric Infectious Diseases, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, (2)The American Congress of Obstetricians and Gynecologists, Washington, DC, (3)Centers for Disease Control and Prevention, Atlanta, GA, (4)Pediatrics, University of Colorado, Aurora, CO, (5)Colorado School of Public Health, Aurora, CO, (6)Denver Health, Denver, CO, (7)University of Colorado Anschutz Medical Campus, Aurora, CO, (8)University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, (9)CDC, Atlanta, GA, (10)Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO

Disclosures:

S. O'Leary, None

L. Riley, None

M. C. Lindley, None

M. Allison, None

L. Crane, None

L. Hurley, None

B. Beaty, None

M. Brtnikova, None

A. Albert, None

A. Fisher, None

A. Jiles, None

A. Kempe, None

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