孕妇流感疫苗接种的覆盖率和决定因素：一项横断面研究。

Coverage and determinants of influenza vaccine among pregnant women: a cross-sectional study.

机构信息

Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore.

London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.

出版信息

BMC Public Health. 2019 Jul 5;19(1):890. doi: 10.1186/s12889-019-7172-8.

DOI:10.1186/s12889-019-7172-8

PMID:31277611

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6612156/

Abstract

BACKGROUND

Pregnant women are at increased risk of influenza-related complications. The World Health Organisation recommends influenza vaccination to this high-risk population as highest priority. However, achieving high influenza vaccine coverage among pregnant women remains challenging. We conducted a cross-sectional survey to estimate the coverage and determinants of influenza vaccination among pregnant women in Singapore.

METHODS

Between September and November 2017, pregnant women aged ≥21 years were recruited at two public hospitals in Singapore. Participants completed an anonymous, self-administered online questionnaire assessing participants' influenza vaccination uptake, knowledge of and attitudes towards influenza and the influenza vaccine, vaccination history, willingness to pay for the influenza vaccine, and external cues to vaccination. We estimated vaccine coverage and used multivariable Poisson models to identify factors associated with vaccine uptake.

RESULTS

Response rate was 61% (500/814). Only 49 women (9.8, 95% Confidence Interval (CI): 7.3-12.7%) reported receiving the vaccine during their current pregnancy. A few misconceptions were identified among participants, such as the belief that influenza can be treated with antibiotics. The most frequent reason for not being vaccinated was lack of recommendation. Women who were personally advised to get vaccinated against influenza during pregnancy were 7 times more likely to be vaccinated (prevalence ratio (PR) = 7.11; 95% CI: 3.92-12.90). However, only 12% of women were personally advised to get vaccinated. Other factors associated with vaccine uptake were vaccination during a previous pregnancy (PR = 2.51; 95% CI: 1.54-4.11), having insurance to cover the cost of the vaccine (PR = 2.32; 95% CI: 1.43-3.76), and higher vaccine confidence (PR = 1.62; 95% CI: 1.30-2.01).

CONCLUSIONS

Influenza vaccination uptake among pregnant women in Singapore is low. There is considerable scope for improving vaccination coverage in this high-risk population through vaccination recommendations from healthcare professionals, and public communication targeting common misconceptions about influenza and influenza vaccines.

摘要

背景

孕妇患流感相关并发症的风险增加。世界卫生组织（WHO）建议将流感疫苗接种作为高危人群的最高优先事项。然而，在孕妇中实现高流感疫苗接种率仍然具有挑战性。我们进行了一项横断面调查，以估计新加坡孕妇的流感疫苗接种率及其决定因素。

方法

2017 年 9 月至 11 月，在新加坡的两家公立医院招募了年龄≥21 岁的孕妇。参与者完成了一份匿名的、自我管理的在线问卷，评估了参与者的流感疫苗接种率、对流感和流感疫苗的知识和态度、疫苗接种史、对流感疫苗的支付意愿以及接种的外部线索。我们估计了疫苗覆盖率，并使用多变量泊松模型来确定与疫苗接种率相关的因素。

结果

应答率为 61%（500/814）。只有 49 名女性（9.8%，95%置信区间（CI）：7.3-12.7%）报告在当前孕期接种了疫苗。在参与者中发现了一些误解，例如认为流感可以用抗生素治疗。未接种疫苗的最常见原因是未被推荐。在怀孕期间被建议接种流感疫苗的女性接种疫苗的可能性是未被建议接种的 7 倍（优势比（PR）=7.11；95%CI：3.92-12.90）。然而，只有 12%的女性被建议接种疫苗。其他与疫苗接种率相关的因素包括在前一次怀孕期间接种疫苗（PR=2.51；95%CI：1.54-4.11）、有保险支付疫苗费用（PR=2.32；95%CI：1.43-3.76）和更高的疫苗信心（PR=1.62；95%CI：1.30-2.01）。