Flu Vaccination Coverage During Pregnancy Rises—But Not Enough.
Influenza vaccination rates during pregnancy increased from 20 percent in 2005–2006 to 41 percent in 2013–2014—a level that falls short of the recommendation that all women who are pregnant during influenza season be vaccinated, according to a new paper by researchers from the Slone Epidemiology Center at BU.
The findings, published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, show that coverage increased during the 2009–2010 pH1N1 pandemic influenza vaccine season to approximately 33 percent, then declined slightly in the next two seasons before increasing again during the 2012–13 and 2013–14 seasons—to 35 percent and 41 percent, respectively.
Overall, nearly 80 percent of the vaccinations received by pregnant women were administered in a traditional health care setting, such as the office of their obstetrician or primary care physician or a prenatal clinic. During the nine flu vaccination seasons reviewed, the proportion of vaccine doses received by women in these settings increased only slightly, from 73 percent to 80 percent. Meanwhile, the proportion of doses received in pharmacy/supermarket settings increased from 4 percent to 8 percent, while those received at work or school decreased from 23 percent in 2006–2007 to 10 percent in 2013–2014.
Pregnant women and their infants are at increased risk for complications from influenza infection. The research team—Stephen Kerr, a research data analyst at Slone; Carla M. Van Bennekom (MPH’86), epidemiologist at Slone; and Allen Mitchell, director emeritus of Slone and professor of epidemiology and pediatrics at the Schools of Public Health and Medicine—used data from the Slone Birth Defects Study, which includes pregnant women in New York and Massachusetts and the areas surrounding Philadelphia and San Diego.
The authors said that while the increase in the vaccination rate was encouraging, the percentage of pregnant women receiving the vaccine “remains far short of the Advisory Committee on Immunization Practices (ACIP) recommendation of flu vaccination for all women who will be pregnant during influenza season.”
The report also cites a CDC finding that during the 2015–2016 influenza season, 63 percent of pregnant women whose health care providers recommended and offered flu vaccinations received the vaccine, compared with 38 percent who received a recommendation, but no offer.
“Incorporating counseling and administration for seasonal influenza vaccine into the routine management of pregnant women can offer the best option for increasing influenza vaccination coverage among this vulnerable group to prevent influenza-associated morbidity and mortality among pregnant women and their infants,” the researchers said.