中国老年人群流感疫苗接种支持性环境演变及地区差异

季节性流感具有较高的疾病负担, 老年人感染流感后容易引起多种并发症。接种流感疫苗可有效预防感染并显著降低并发症和重症发生风险。提供疫苗接种相关支持性环境对提高老年人群流感疫苗接种率有着重要作用。在我国, 当前针对老年人群流感疫苗的支持性环境主要包括老年人群流感疫苗免费接种政策和费用报销政策等, 不同城市或地区间存在显著的地区差异。本研究对我国老年人群流感疫苗接种相关的支持性环境和地区差异进行系统梳理, 以了解当前流感疫苗接种的背景环境带来的流感防控机会和地区差异可能导致的健康不平等挑战, 为国家相关政策和民生项目的出台提供科学参考。     

流感疫苗在高危人群中应用安全性、有效性及接种现状研究新进展

对2020年国内外不同高危人群流感疫苗应用情况发表的相关研究进展进行综述。流感疫苗在高危人群中接种的重要性得到了更多大样本、多中心、高质量循证证据的支持。接种流感疫苗是预防流感最经济有效的措施,目前我国流感疫苗接种率很低,需进一步加大对各类人群流感疫苗接种的科普宣传与教育。建议流感季来临前对研究证据明确的疫苗接种安全有...     

流感疫苗公费接种项目方案专家共识

近年来,中国全人群流感疫苗接种率约为2%。目前我国已有部分地区通过民生项目、惠民政策等形式针对老年人、学龄儿童、医务人员等特定人群开展流感疫苗免费接种项目,即"流感公费项目",显著提高了目标人群的流感疫苗接种率。为促进流感公费项目在全国范围内科学有序的开展,湖南省预防医学会组织相关领域专家在对欧美一些国家流感疫苗应用策略进行研究的基础上,结合我国相关政策、技术指南及以往经验,对流感公费项目的目的、确立、实施及组织管理进行全面的阐述;同时,也对流感公费项目实施情况的评价指标包括接种率、疫苗效果、安全性、成本-效益等和评价方法进行了介绍,为有意愿实施或已开展流感疫苗公费项目的地区提供参考。     

郑州市孕妇接种流行性感冒疫苗的意愿及影响因素分析

目的 了解孕妇接种流行性感冒(简称流感) 疫苗的意愿及其影响因素,为推广孕妇接种流感疫苗提供依据。 方法 采用整群随机抽样方法,从2019年1月—2020年4月在郑州大学第一附属医院建档在册的孕妇中随机抽取2019年12月建档在册835例孕妇进行流感疫苗接种意愿问卷调查。采用单因素χ²检验和多因素logistic回归分析孕妇接种流感疫苗意愿的影响因素。 结果 调查的835例孕妇的年龄范围为20~45岁,平均(29.61±3.87)岁,愿意接种流感疫苗的孕妇占32.57%, 拒绝孕期接种流感疫苗的主要原因为担心对胎儿有不良影响(55.24%)及疫苗不良反应(43.52%)。对孕期接种意愿影响最大的因素为孕期接种流感疫苗知识知晓得分≥10 分(OR=2.323,95%CI:1.681~3.210),以及医生推荐接种(OR=2.151,95%CI:1.572~2.944)。此外年龄≥35 岁、孕期合并慢性疾病、家人接种流感疫苗、孕期感染流感病毒的危害知晓得分≥10分和知晓接种推荐政策也影响孕妇的疫苗接种意愿。 结论 郑州市孕妇对接种流感疫苗的意愿较低。建议加强流感疫苗接种相关知识的宣传,充分发挥医生的指导作用,积极推动孕妇的流感疫苗接种普及工作。     

中国流感疫苗预防接种技术指南(2023-2024)

流感是由流感病毒引起的一种急性呼吸道传染病, 严重危害人群健康。流感病毒抗原性易变, 传播迅速, 每年可引起季节性流行, 在学校、托幼机构和养老院等人群聚集的场所易发生暴发疫情。每年季节性流感流行在全球可导致300万～500万重症病例, 29万～65万呼吸道疾病相关死亡。孕妇、婴幼儿、老年人和慢性基础性疾病患者等高危人群, 患流感后出现严重疾病和死亡的风险较高。2023年2月中旬至4月底, 我国呈现一波以甲型H1N1亚型为主的流感流行季, 强度略高于新冠疫情前的自然流行年份, 今冬明春可能会面临新冠、流感等呼吸道传染病交互或共同流行的风险。接种流感疫苗是预防流感、减少流感相关重症和死亡的有效手段, 可以减少流感相关疾病带来的危害及对医疗资源的挤兑。我国现已批准上市的流感疫苗有三价灭活流感疫苗(IIV3)、四价灭活流感疫苗(IIV4)和三价减毒活流感疫苗(LAIV3), 其中IIV3和IIV4包括裂解疫苗和亚单位疫苗, LAIV3为减毒疫苗。流感疫苗在我国属于非免疫规划类疫苗, 居民自愿接种。自2018年起, 中国疾病预防控制中心在每年流感流行季之前均更新并印发当年度的《中国流感疫苗预防...     

中国流感疫苗预防接种技术指南（2022-2023）

流感是由流感病毒引起的一种急性呼吸道传染病,严重危害人群健康。流感病毒其抗原性易变,传播迅速,每年可引起季节性流行,在学校、托幼机构和养老院等人群聚集的场所易发生暴发疫情。每年季节性流感流行在全球可导致300万~500万重症病例,29万~65万呼吸道疾病相关死亡。孕妇、婴幼儿、老年人和慢性基础疾病患者等高危人群,患流感后出现严重疾病和死亡的风险较高。尤其是全球新型冠状病毒肺炎（新冠肺炎）疫情严重流行态势仍在持续,今年我国南方部分省份出现夏季流感流行高峰,今冬明春可能会出现新冠肺炎与流感等呼吸道传染病叠加流行的情况。接种流感疫苗是预防流感、减少流感相关重症和死亡的有效手段,可以减少流感相关疾病带来的健康危害及对医疗资源的挤兑。我国现已批准上市的流感疫苗有三价灭活流感疫苗（IIV3）、四价灭活流感疫苗（IIV4）和三价减毒活流感疫苗（LAIV3）,IIV3包括裂解疫苗和亚单位疫苗,IIV4为裂解疫苗,LAIV3为减毒疫苗。流感疫苗在我国属于非免疫规划类疫苗,居民自愿接种。2018年以来,中国疾病预防控制中心每年印发当年度的《中国流感疫苗预防接种技术指南》。一年来,新的研究证据在国内外发表,为更好地指导我国流感预防控制和疫苗接种工作,国家免疫规划技术工作组流感疫苗工作组综合国内外最新研究进展,在2021年版指南的基础上进行了更新和修订,形成了《中国流感疫苗预防接种技术指南（2022-2023）》。本指南更新的内容主要包括：第一,增加了新的研究证据,尤其是我国的研究结果,包括流感疾病负担、疫苗效果、疫苗安全性监测、疫苗预防接种成本效果等;第二,更新了一年来国家出台的有关流感防控政策和措施;第三,更新了2022-2023年度国内批准上市及批签发的流感疫苗种类;第四,更新了本年度三价和四价流感疫苗组分;第五,更新了2022-2023年度的流感疫苗接种建议。本指南建议：原则上,接种单位应为≥6月龄所有愿意接种流感疫苗且无接种禁忌的人提供接种服务。≥18岁的人群可在一次接受免疫服务时,在两侧肢体分别接种灭活流感疫苗和新型冠状病毒疫苗（新冠疫苗）;<18岁的人群,建议流感疫苗与新冠疫苗接种间隔仍>14 d。对可接种不同类型或不同厂家疫苗产品的人群,可由受种者自愿选择接种任何一种流感疫苗,无优先推荐。结合今年新冠肺炎疫情形势,为尽可能降低流感的危害和对新冠肺炎疫情防控的影响,优先推荐以下重点和高风险人群及时接种：①医务人员,包括临床救治人员、公共卫生人员、卫生检疫人员等;②大型活动参加人员和保障人员;③养老机构、长期护理机构、福利院等人群聚集场所脆弱人群及员工;④重点场所人群,如托幼机构、中小学校的教师和学生,监所机构的在押人员及工作人员等;⑤其他流感高风险人群,包括≥60岁居家老年人、6月龄至5岁儿童、慢性病患者、6月龄以下婴儿的家庭成员和看护人员以及孕妇。对于IIV,6月龄至8岁儿童首次接种流感疫苗的应接种2剂次,间隔≥4周;2021-2022年度或以前接种过1剂次或以上流感疫苗的儿童,建议接种1剂次;≥9岁儿童和成年人仅需接种1剂次。对于LAIV,无论是否接种过流感疫苗,仅接种1剂次。建议各地在疫苗供应到位后尽早开展接种工作,尽量在当地流感流行季前完成接种。同一流行季,已按照接种程序完成全程接种的人员,无需再次接种。孕妇在孕期的任一阶段均可接种灭活流感疫苗。接种单位在整个流行季节都可以提供接种服务。本指南适用于疾控机构、医疗机构、妇幼保健机构和接种单位等从事流感防治相关的专业人员。根据国内外研究进展,本指南今后亦将定期更新、完善。     

北京通州区中小学生免费流感疫苗接种及影响因素分析

了解北京市通州区中小学生免费流感疫苗接种情况及相关影响因素,为有效促进流感疫苗接种提供参考.方法 2014年12月-2015年2月,采用两阶段抽样的方法,抽取通州区8所学校2012年9月前入学的706名在校学生,采用自行设计的问卷对学生家长进行调查,获取相关调查信息.结果 2012-2014年流感疫苗接种率分别为78.72%,77.16%,69.58%,而2012-2014年连续3年均进行流感疫苗接种的人群仅占57.11%.家长不愿意为孩子进行流感疫苗接种的主要原因是担心流感疫苗质量和安全性(67.38%)、认为接种流感疫苗不能降低患流感的可能(37.34%).多分类Logistic回归分析结果显示,家长是否知晓流感疫苗需要每年接种以及家长是否了解流感疫苗可降低患流感的可能性是影响中小学生免费流感疫苗接种的因素(P值均<0.05).结论 北京市通州区中小学生流感疫苗调查接种率逐年下降,主要影响因素涉及家长对疫苗接种知识认知不足、不了解流感疫苗使用效果及推荐程序,疫苗接种宣传手段创新不足,宣传服务与家长需求存在较大差距.应采取多方联合宣传途径更好的开展流感疫苗接种工作.     

基层医务人员流感疫苗接种知信行调查

目的调查基层医务人员流感疫苗接种知信行现况。方法于2016年9月对宁波市江东区5家街道社区卫生服务中心的392名医务人员进行问卷调查,内容包括基本情况、流感相关知识、流感疫苗接种情况和流感疫苗接种意愿,分析流感疫苗接种知信行现况及影响因素。结果发放问卷392份,回收有效问卷389份,有效率为99.23%。医务人员流感相关知识总体知晓率为76.92%,不同最高学历专业、工作科室的医务人员流感相关知识得分差异有统计学意义(均P0.05)。139名医务人员接种过流感疫苗,接种率为35.73%;260名医务人员愿意接种流感疫苗,接种意愿率为66.84%。Logistic回归分析结果显示,工作年限5年(OR:2.61~3.86)和参加健康教育活动(OR=2.24)是接种流感疫苗的促进因素;最高学历专业为非预防医学专业(OR:0.15~0.27)是接种流感疫苗的阻碍因素;流感相关知识得分≥8分(OR=2.95)和接种过流感疫苗(OR=6.09)是愿意接种流感疫苗的促进因素。结论江东区基层医务人员流感相关知识知晓率、流感疫苗接种率和接种意愿率均较低,应加强相关知识的健康教育。     

中国流感疫苗预防接种技术指南(2020—2021)

流感是由流感病毒引起的一种急性呼吸道传染病, 严重危害人群健康。流感病毒其抗原性易变, 传播迅速, 每年可引起季节性流行, 在学校、托幼机构和养老院等人群聚集的场所可发生暴发疫情。每年流感季节性流行在全球可导致300万～500万重症病例, 29万～65万呼吸道疾病相关死亡。孕妇、婴幼儿、老年人和慢性基础疾病患者等高危人群, 患流感后出现严重疾病和死亡的风险较高。尤其是今年全球新冠疫情严重流行态势仍将持续, 今冬明春可能会出现新冠疫情与流感等呼吸道传染病叠加流行的情况。而接种流感疫苗是预防流感的最有效手段, 可以减少流感相关疾病带来的危害及对医疗资源的占用。我国现已批准上市的流感疫苗有三价灭活流感疫苗(IIV3)、四价灭活流感疫苗(IIV4)和三价减毒活流感疫苗(LAIV3), IIV3包括裂解疫苗和亚单位疫苗, IIV4为裂解疫苗, LAIV为减毒疫苗。除个别地区外, 流感疫苗在我国大多数地区属于非免疫规划类疫苗, 实行自愿、自费接种。2018年和2019年, 中国疾病预防控制中心均印发了当年度的《中国流感疫苗预防接种技术指南》。一年来, 新的研究证据在国内外发表, 新的疫苗产品在我国...     

广州市育龄妇女对孕期接种季节性流感疫苗的意愿调查

目的了解广州市育龄妇女对孕期接种季节性流感疫苗(以下简称流感疫苗)的意愿和影响因素,为促进孕期接种流感疫苗工作提供参考。方法采用分层随机抽样方法随机抽取广州市医疗机构门诊孕妇和民政局未孕育龄妇女开展问卷调查,调查内容包括人口学资料、孕期接种流感疫苗意愿和主观原因、流感认知和流感疫苗接种史等,采用单、多因素分析方法进行接种意愿影响因素分析。结果 50.8%(122/240)的调查对象表示如果知晓国家已将孕妇纳为流感疫苗的接种对象,将愿意接种。愿意接种的主要原因是"产科医生推荐"(74.6%,91/122)和"预防接种医生推荐"(42.6%,52/122),不愿意接种的主要原因是"担心胎儿出生缺陷"(54.2%,64/118)和"接种疫苗有不良反应"(44.9%,53/118)。多因素分析结果显示,流感疫苗认知水平对接种意愿有影响(OR=1.678,95%CI:1.307~2.155)。结论广州市育龄妇女对孕期接种流感疫苗的意愿偏低,应加强育龄妇女和医务人员对疫苗接种策略和安全性的宣传教育,提高孕期流感疫苗接种率。     

Effectiveness of influenza vaccination during pregnancy to prevent severe infection in children under 6 months of age,Spain, 2017–2019

IntroductionInfluenza vaccination is recommended to pregnant women in Spain to reduce the risk of influenza-related complications. Influenza related hospitalizations pose a significant disease burden in children every year. Although children below 6 months are too young to be vaccinated, they can receive protection against influenza through vaccination of their mothers during pregnancy. We estimated the effectiveness of maternal influenza vaccination to prevent influenza hospitalizations in infants under 6 months of age.MethodsThis is a retrospective pilot study, using data from the Severe Hospitalized Confirmed Influenza Cases (SHCIC) surveillance system in seasons 2017/18 and 2018/19 in Spain. Maternal vaccination status during pregnancy was collected for cases in children 6 months and younger hospitalized with confirmed influenza infection. Influenza vaccine effectiveness was estimated using the screening method, by comparing the proportion of children with vaccinated mothers during pregnancy (proportion of cases vaccinated, PCV), with the vaccination coverage among pregnant women in Spain (proportion of population vaccinated, PPV).ResultsFor all the study period, the PCV was 17% and the PPV was 35%. Influenza vaccination in mothers during pregnancy prevented influenza confirmed hospitalizations in infants aged 6 months and younger with a 61% (95%CI: 27–79%) effectiveness.ConclusionsIn line with evidence from other countries, influenza vaccination during pregnancy protects infants up to 6 months of age from influenza hospitalizations in Spain. These results support current recommendations of influenza vaccination in pregnant women, and more studies are needed in Spain to confirm the double protection of maternal vaccination in mothers and infants.     

孕期妇女接种流行性感冒疫苗影响因素研究综述

流行性感冒（流感）是一种急性呼吸道传染病,孕期妇女（孕妇）感染流感病毒可导致严重并发症的出现。接种流感疫苗是目前孕妇及〈6月龄婴儿预防流感的最有效措施。该文旨在对孕妇接种流感疫苗的影响因素研究进行综述。     

Report of the WHO technical consultation on the effect of maternal influenza and influenza vaccination on the developing fetus: Montreal,Canada, September 30–October 1, 2015

In 2012, the World Health Organization (WHO) released a position paper on influenza vaccination recommending that pregnant women have the highest priority for seasonal vaccination in countries where the initiation or expansion of influenza immunization programs is under consideration. Although the primary goal of the WHO recommendation is to prevent influenza illness in pregnant women, the potential benefits of maternal immunization in protecting young infants are also recognized. The extent to which maternal influenza vaccination may prevent adverse birth outcomes such as preterm birth or small-for-gestational-age birth, however, is unclear as available studies are in disagreement.To inform WHO about the empirical evidence relating to possible benefits of influenza vaccination on birth outcomes, a consultation of experts was held in Montreal, Canada, September 30–October 1, 2015. Presentations and discussions covered a broad range of issues, including influenza virus infection during pregnancy and its effect on the health of the mother and the fetus, possible biological mechanisms for adverse birth outcomes following maternal influenza illness, evidence on birth outcomes following influenza illness during pregnancy, evidence from both observational studies and randomized controlled trials on birth outcomes following influenza vaccination of pregnant women, and methodological issues. This report provides an overview of the presentations, discussions and conclusions.     

Knowledge,attitudes, and practices of healthcare providers in the country of Georgia regarding influenza vaccinations for pregnant women

ObjectiveTo document knowledge, attitudes, and practices of Georgian obstetrician-gynecologists concerning influenza infection and vaccination during pregnancy.MethodsWe conducted a cross-sectional study of obstetrician-gynecologists in 8 cities in the country of Georgian, from June to July, 2015, using an anonymous, self-administered, written survey. Collected data included demographics; knowledge, attitudes, and practices related to influenza vaccination during pregnancy; perceptions of influenza infection in pregnancy; perceived barriers to influenza vaccination during pregnancy; and willingness to receive education about influenza infection and vaccination during pregnancy.ResultsA total of 278 obstetrician-gynecologists completed surveys. Most physicians perceived influenza to be a serious infectious disease (88%) and that pregnant women are more susceptible to it than the general population. Only 43% of physicians reported recommending influenza vaccination during pregnancy; 18% reported vaccinating any pregnant patients during the last influenza season. Most (75%) physicians reported a perception that there is insufficient evidence supporting influenza vaccination during pregnancy. Most (93%) were receptive to receiving additional education on maternal vaccination.ConclusionsGeorgian physicians are hesitant to vaccinate pregnant women, but are receptive to education about maternal vaccination. Future educational outreach to Georgian physicians could reduce concerns about maternal vaccination, potentially increasing influenza vaccination among pregnant Georgian women.     

Knowledge and attitudes towards influenza and influenza vaccination among pregnant women in Kenya

BackgroundInfluenza vaccination during pregnancy benefits mothers and children. Kenya and other low- and middle-income countries have no official influenza vaccination policies to date but are moving towards issuing such policies. Understanding determinants of influenza vaccine uptake during pregnancy in these settings is important to inform policy decisions and vaccination rollout.MethodsWe interviewed a convenience sample of women at antenatal care facilities in four counties (Nairobi, Mombasa, Marsabit, Siaya) in Kenya. We described knowledge and attitudes regarding influenza vaccination and assessed factors associated with willingness to receive influenza vaccine.ResultsWe enrolled 507 pregnant women, median age was 26 years (range 15–43). Almost half (n = 240) had primary or no education. Overall, 369 (72.8%) women had heard of influenza. Among those, 288 (78.1%) believed that a pregnant woman would be protected if vaccinated, 252 (68.3%) thought it was safe to receive a vaccine while pregnant, and 223 (60.4%) believed a baby would be protected if mother was vaccinated. If given opportunity, 309 (83.7%) pregnant women were willing to receive the vaccine. Factors associated with willingness to receive influenza vaccine were mothers’ belief in protective effect (OR 3.87; 95% CI 1.56, 9.59) and safety (OR 5.32; 95% CI 2.35, 12.01) of influenza vaccines during pregnancy.ConclusionApproximately one third of pregnant women interviewed had never heard of influenza. Willingness to receive influenza vaccine was high among women who had heard about influenza. If the Kenyan government recommends influenza vaccine for pregnant women, mitigation of safety concerns and education on the benefits of vaccination could be the most effective strategies to improve vaccine acceptance.     

苏州市2015-2018年孕产妇季节性流感病毒感染的影响因素研究

目的 探讨2015-2018年苏州市孕产妇季节性流感病毒感染的影响因素。方法 基于2015-2018年在苏州市开展的孕产妇人群流感随访队列资料，描述队列人群的基本情况和流感病毒感染后的临床特征，采用非条件logistic回归分析孕产妇实验室确诊流感病毒感染的影响因素。结果 共招募19 006名孕产妇，其中实验室确诊流感病例479名，A（H3N2）（42.8%）为主要的病毒亚型。在有流感流行期暴露风险的人群中，非条件单因素logistic回归分析结果显示，孕产妇或者其丈夫户籍在苏州市、职业为保育员及保姆、除本人外家中常住人口>2人、在苏州市有医疗保险、在苏州有生育险、纳入时为孕晚期、近一个月有过咳嗽、第一次怀孕、已有孩子、怀孕前后户外时间比以前多、怀孕前后戴口罩频率比以前多、怀孕前后聚会频率有改变均与孕产妇流感病毒感染有关，其中第一次怀孕、怀孕前后户外时间比以前多、怀孕前后戴口罩频率比以前多、怀孕前后聚会频率有改变为保护因素；非条件多因素logistic回归分析结果显示，家中常住人口>2人（aOR=1.24，95%CI：1.01~1.52）、孕晚期（aOR=1.56，95%CI：1.26~1.91）是孕产妇感染流感病毒的危险因素。结论 家中常住人口数较多及孕晚期的孕产妇更要注意预防季节性流感。     

Assessment of indirect protection from maternal influenza immunization among non-vaccinated household family members in a randomized controlled trial in Sarlahi,Nepal

Influenza is a significant cause of morbidity and mortality worldwide, and the World Health Organization highly recommends maternal vaccination during pregnancy. The indirect effect of maternal vaccination on other close contacts other than newborns is unknown. To evaluate this, we conducted a nested substudy between 2011 and 2012 of influenza and acute respiratory illness (ARI) among household members of pregnant women enrolled in a randomized placebo-controlled trial of antenatal influenza vaccination in the rural district of Sarlahi, Nepal. Women were assigned to receive influenza vaccination or placebo during pregnancy and then they and their household members were followed up to 6 months postpartum with weekly symptom surveillance and nasal swab collection. Swabs were tested by RT-PCR for influenza. Rates of laboratory-confirmed influenza and of ARI were compared between vaccine and placebo groups using generalized estimating equations with a Poisson link function. Overall, 1752 individuals in 520 households were eligible for inclusion. There were 82 laboratory-confirmed influenza illness episodes, for a rate of 7.0 per 100 person-years overall. Of the influenza strains able to be typed, 29 were influenza A, 40 were influenza B, and 6 were coinfections with influenza A and B. The rate did not differ significantly whether the household was in the vaccine or placebo group (rate ratio (RR) 1.37, 95% confidence interval (CI) 0.83–2.26). The rate of ARI was 28.5 per 100 person-years overall and did not differ by household group (RR 0.99, 95% CI 0.72–1.36). Influenza vaccination of pregnant women did not provide indirect protection of unvaccinated household members.     

Cross-sectional study on factors associated with influenza vaccine uptake and pertussis vaccination status among pregnant women in Germany

Pregnant women and their newborns are at increased risk for influenza-related complications; the latter also have an increased risk for pertussis-related complications. In Germany, seasonal influenza vaccination is recommended for pregnant women since 2010. A dose of pertussis-containing vaccine has been recommended since 2004 for women of childbearing age if they have not been vaccinated within the past 10 years. We conducted a nationwide cross-sectional survey among pregnant women in February/March 2013 to assess knowledge, attitudes, and practices related to influenza vaccination during pregnancy and to identify factors associated with their pertussis vaccination status. In total, 1025 pregnant women participated and provided information through a self-administered questionnaire. Of these, 23.2% were vaccinated against seasonal influenza during the 2012/13 season; 15.9% during their pregnancy. Major reasons for being unvaccinated (n = 686 respondents) were lack of confidence in the vaccine (60.4%) and the perception that vaccination was not necessary (40.3%). Influenza vaccination during pregnancy was independently associated with having received influenza vaccine in the previous season, having received a recommendation from a physician, a high level of vaccine-related knowledge and of perceived disease severity. In contrast, knowledge of the recommendation for regular hand-washing to prevent influenza and the perception that vaccine-related side effects were likely to occur or likely to be severe were negatively associated with vaccine uptake. Receipt of a pertussis vaccine in the past 10 years was reported by 22.5% of participants. Pertussis vaccine uptake was independently associated with living in the Eastern federal states and receiving seasonal influenza vaccination annually, while a migration background was associated with a lower uptake. To enhance vaccine uptake in pregnant women and women of childbearing age, special efforts must be undertaken to improve knowledge of both recommendations and the benefits of vaccination. Gynecologists could serve as important facilitators.     

Identifying ways to increase seasonal influenza vaccine uptake among pregnant women in China: A qualitative investigation of pregnant women and their obstetricians

BackgroundPregnant women are at higher risk for complications from influenza infection. Nevertheless, seasonal influenza vaccination among pregnant women in China is low. A better understanding of perceptions of pregnant women and their physicians, and factors influencing decisions about receiving seasonal influenza vaccine could be used to develop effective strategies for improving seasonal influenza vaccine uptake during pregnancy.MethodsWe recruited pregnant women from 9 hospitals located in 5 cities across China to participate in focus group interviews. Obstetricians from the same hospitals were recruited for one on one in-depth interviews. We collected information about perceptions of barriers and motivating factors for utilizing seasonal influenza vaccine during pregnancy. We systematically analyzed the information using qualitative methods.ResultsWe conducted 18 focus groups with 108 pregnant women and interviewed 18 obstetricians. Awareness about the use of influenza vaccine during pregnancy was minimal in both subject groups. None of the pregnant women had received influenza vaccine during pregnancy and none of the obstetricians had recommended influenza vaccine for their patients. Both groups noted insufficient knowledge about influenza infection and benefits of the vaccine, concerns about vaccine safety, and lack of local data related to vaccine use in Chinese pregnant women. Obstetricians cited the lack of a national policy as a major barrier to recommending seasonal influenza vaccine to pregnant women. Pregnant women cited not receiving a recommendation for vaccination from healthcare workers as an additional barrier.ConclusionOur findings highlight the immediate need to increase awareness and knowledge about the risks of influenza infection and the benefits and safety of seasonal influenza vaccination among both pregnant women and obstetricians in China. Obstetricians interviewed stated that the development and implementation of a national policy prioritizing pregnant women for seasonal influenza vaccination would facilitate their willingness to recommend seasonal influenza vaccine to pregnant women.