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Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population.

ABSTRACT: Influenza infection in pregnant women is associated with increased risk of morbidity and mortality. Despite recommendations for all women to receive the seasonal influenza vaccine during pregnancy, vaccination rates among pregnant women in the U.S. have remained around 50%. The objective of this study was to evaluate clinical and demographic factors associated with antenatal influenza vaccination in a medically underserved population of women. We conducted a retrospective cohort study at Grady Memorial Hospital, a large safety-net hospital in Atlanta, Georgia, from July 1, 2016, to June 30, 2018. Demographic and clinical characteristics were abstracted from the electronic medical record. The Kotelchuck index was used to assess prenatal care adequacy. Relative risks and 95% confidence intervals for associations between receipt of influenza vaccine and prenatal care adequacy, demographic characteristics, and clinical characteristics were calculated using multivariable log-binominal models. Among 3723 pregnant women with deliveries, women were primarily non-Hispanic black (68.4%) and had Medicaid as their primary insurance type (87.9%). The overall vaccination rate was 49.8% (1853/3723). Inadequate prenatal care adequacy was associated with a lower antenatal influenza vaccination rate (43.5%), while intermediate and higher levels of prenatal care adequacy were associated with higher vaccination rates (66.9-68.3%). Hispanic ethnicity, non-Hispanic other race/ethnicity, interpreter use for a language other than Spanish, and preexisting diabetes mellitus were associated with higher vaccination coverage in multivariable analyses. Among medically underserved pregnant women, inadequate prenatal care utilization was associated with a lower rate of antenatal influenza vaccination. Socially disadvantaged women may face individual and structural barriers when accessing prenatal care, suggesting that evidenced-based, tailored approaches may be needed to improve prenatal care utilization and antenatal influenza vaccination rates.

SUBMITTER: Adams JC

PROVIDER: S-EPMC7204164 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population.

Adams Jenna C JC Biswas Hope H HH Boulet Sheree L SL Doraivelu Kamini K Saums Michele K MK Haddad Lisa L Jamieson Denise J DJ

Infectious diseases in obstetrics and gynecology 20200127

Influenza infection in pregnant women is associated with increased risk of morbidity and mortality. Despite recommendations for all women to receive the seasonal influenza vaccine during pregnancy, vaccination rates among pregnant women in the U.S. have remained around 50%. The objective of this study was to evaluate clinical and demographic factors associated with antenatal influenza vaccination in a medically underserved population of women. We conducted a retrospective cohort study at Grady M ...[more]

PMID: 32410818

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Project description:BACKGROUND: The rate of influenza vaccination in Japan has declined over the past several decades. It is essential to identify community-specific factors that affect attitudes toward vaccination, but such parameters have not yet been fully determined in Japan. The present study used the Health Belief Model (HBM) to identify perceptions of influenza vaccination in a rural Japanese community. METHODS: All subjects were residents of a rural town in the southern part of Kyoto, Japan. An anonymous self-administered questionnaire was mailed to 846 randomly chosen households (containing 2,665 subjects). The survey explored gender, age, history of influenza, and factors associated with obtaining influenza vaccination, based on the HBM. RESULTS: A total of 1,182 valid responses (response rate, 44.4%) were received. Sources of information that were associated with vaccination decisions were medical facilities for children (OR=4.21; 95% CI: 1.17-15.1), workplaces for adults (OR=2.40; 95% CI: 1.22-4.75), medical facilities, town office and family for elderly subjects (OR=6.18; 95% CI: 2.42-15.7, OR=5.59; 95% CI: 2.26-13.8 and OR=3.29; 95% CI: 1.01-10.6). Subjects, in all age groups, who strongly agreed that the vaccine was effective were significantly more likely to be vaccinated (OR=10.5; 95% CI: 2.68-41.7 for children; OR=8.85; 95% CI: 4.61-16.9 for adults; OR=19.9; 95% CI: 8.28-48.0 for the elderly). The vaccination rate of elderly subjects who expressed concerns regarding adverse vaccine effects (OR=0.34, 95% CI: 0.15-0.78) or who were worried about practical barriers to the vaccination process (OR=0.13; 95% CI: 0.05-0.31) was significantly lower than in other populations. CONCLUSIONS: Our results indicate that vaccination coverage can be increased if accurate information on personal risk, severity of influenza illness, and efficacy of vaccination are provided by responsible information sources that are easily accessible. Such sources include medical facilities and municipal offices. In addition, barriers and inconveniences associated with vaccination should be removed, especially if they impact on elderly people.

Project description:BACKGROUND:Vaccinating children against influenza has shown both direct and indirect beneficial effects. However, despite being offered free of charge, childhood influenza vaccine coverage in Israel has been low. Our objective was to evaluate the factors associated with childhood influenza vaccination in Israel. METHODS:A cross-sectional language-specific telephone survey was conducted among adults 18?years or older, to examine childhood influenza vaccination practices and their associations with socio-demographic and relevant health variables. We further explored the reasons for these practices among parents. Multivariate logistic regression was used to identify factors associated with childhood influenza vaccine acceptance. RESULTS:Of a total of 6518 individuals contacted by mobile phone, 1165 eligible parents, ?18?years old with children 1-18?years of age, were interviewed, and 1040 of them completed the survey successfully. Overall, factors associated with childhood influenza vaccination were younger child's age, influenza vaccination of other family members and belonging to the Arab population group. No association was found between childhood influenza vaccination and routine childhood vaccine uptake. Several of the parents' reasons for vaccine acceptance - preventing influenza or its transmission, awareness regarding the need for influenza vaccination and receipt of invitation to get vaccinated - differed significantly between Jewish and Arab parents. Several reasons reported by parents for not vaccinating children against influenza, indicated a likelihood to accept influenza vaccine outreach efforts. Such reasons were reported by 27.5% of Jewish parents and 37.5% of Arab parents. CONCLUSIONS:We found that certain demographic factors were associated with childhood influenza vaccination in Israel. Several reasons described by the parent for not vaccinating their children indicate that outreach efforts are likely to increase childhood influenza vaccination. Addressing population group-specific needs is recommended to optimize the success of influenza vaccine outreach efforts.

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Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population.

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Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population.

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