Interventions to increase the uptake of seasonal influenza vaccination among pregnant women: A systematic review |
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| Institution: | 1. School of Nursing, Li Ka Shing Faculty of Medicine, 21 Sassoon Road, Pokfulam, Hong Kong;2. College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, United States;1. Emory University, Department of Epidemiology and Laney Graduate School, Atlanta, GA, United States;2. Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, and Division of Infectious Diseases, Department of Medicine, Atlanta, GA, United States;3. Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA, United States;4. Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, United States;5. Emory University, School of Medicine, Department of Gynecology and Obstetrics, Atlanta, GA, United States;6. University of Kansas Medical Center, Department of Obstetrics and Gynecology, Kansas City, KS, United States;7. Emory University, Emory Vaccine Center and School of Medicine, Atlanta, GA, United States;8. Emory University, Department of Pediatrics, Atlanta, GA, United States;1. Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR Room 3040Z, Atlanta, GA 30322, USA;2. Division of Infectious Diseases, School of Medicine, Emory University, 1462 Clifton Rd. NE, Room 446, Atlanta, GA 30322, USA;3. Department of Gynecology and Obstetrics, School of Medicine, Emory University, 1365 Clifton Road, Building A, 4th Floor, Atlanta, GA 30322, USA;4. Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, GCR Room 472, Atlanta, GA 30322, USA;5. Department of Medicine, Division of Infectious Diseases, 500 Irvin Court, Decatur, GA 30030, USA;6. Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA;7. Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd. NE, CNR Room 3047, Atlanta, GA 30322, USA;8. Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Road NE, CNR Room 3045, Atlanta, GA 30322, USA;9. Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR Room 7017, Atlanta, GA 30322, USA;1. KU Leuven, University of Leuven, Department of Pharmaceutical and Pharmacological Sciences, Leuven University Vaccinology Center (LUVAC), B-3000 Leuven, Belgium;2. KU Leuven, University of Leuven, Department of Public Health and Primary Care, Centre for Environment and Health, Youth Health Care, B-3000 Leuven, Belgium;3. KU Leuven, University of Leuven, Department of Development and Regeneration, Department of Obstetrics and Gynaecology, University Hospitals Leuven, B-3000 Leuven, Belgium;1. Department of Pediatrics, Infectious Diseases Section, Baylor College of Medicine, Houston, TX 77030, USA;2. Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA;3. Center for Vaccine Awareness and Research, Texas Children''s Hospital, Houston, TX 77030, USA;1. NSW Public Health Officer Training Program, NSW Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia;2. School of Public Health and Community Medicine, University of New South Wales, UNSW, Sydney 2052, Australia;3. South Western Sydney and Sydney Local Health Districts Public Health Unit, King George V, Missenden Road, Camperdown, NSW 2050, Australia;4. Health Services and Practice Research Group, Faculty of Health, University of Technology Sydney, 235-253 Jones St Ultimo, NSW 2000, Australia;5. National Centre for Immunisation Research and Surveillance, Hawkesbury Road, Westmead, NSW 2145, Australia;6. Discipline of Paediatrics & Child Health, The University of Sydney, Sydney, NSW 2000, Australia |
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| Abstract: | BackgroundPregnant women and their infants under 6 months of age infected with influenza have a high risk of serious morbidity and mortality. Influenza vaccine during pregnancy offers 3-for-1 benefits to pregnant women, fetuses and newborn infants. Current vaccination uptake rates during pregnancy, however, are often lower than other high-risk groups and the general population.MethodsWe systematically reviewed evidence on the effectiveness of interventions to improve influenza vaccination coverage in pregnant women. Risk differences (RDs) were calculated from the included studies.ResultsEleven studies were included in the review, of which four were randomized controlled trials (RCTs). Three cohort studies assessed provider-focused interventions while four RCTs and one cohort study evaluated pregnant women-focused interventions. Two cohort studies and a prospective intervention study assessed the effectiveness of bundled interventions. No study solely assessed the effectiveness of interventions to enhance access to influenza vaccination. One moderate quality RCT showed that an influenza pamphlet, with or without a verbalized benefit statement, improved the vaccination rate (RD = 0.26; RD = 0.39). The other reviewed RCTs showed discordant results, with RDs ranging from ?0.15 to 0.03. Although all observational studies significantly improved vaccination rates (RDs ranged from 0.03 to 0.44), the quality of the evidence varied.ConclusionsThere is a lack of effective interventions to increase the influenza vaccination rate in pregnant women. Based on the existing research, we recommend that clinicians provide influenza pamphlets to pregnant women with a verbalized statement about the benefits of influenza vaccine to newborns. Further high-quality RCTs are needed to develop successful maternal influenza vaccination programs. Increased clarity in reporting the content of interventions would help to improve the comparability and generalizability of the published studies. |
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| Keywords: | Influenza Flu Vaccine Immunization Pregnancy Pregnant women Infant Intervention Strategies |
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