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孕妇季节性流感疫苗:妇产科医生的观点和经验。

Seasonal Influenza Vaccine in Pregnant Women: Views and Experiences of Obstetrician-Gynecologists.

机构信息

Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

出版信息

J Womens Health (Larchmt). 2021 Aug;30(8):1086-1094. doi: 10.1089/jwh.2020.8700. Epub 2021 Feb 2.

Abstract

Seasonal influenza vaccination rates among pregnant women remain well below the Healthy People 2020 target of 80%. Obstetrician-gynecologist (OB/GYN) recommendations are a critical means of encouraging pregnant women to get vaccinated, but there are limited data about their views. A nationally representative survey of 506 practicing OB/GYNs was completed between October 26, 2015, and May 8, 2016. Analyses included univariate distributions and comparisons based on age, size of practice, and academic affiliation using all-pairs, dependent -tests. A majority of OB/GYNs report they "strongly recommend" seasonal influenza vaccination for their pregnant patients in the first (79%) or second and third trimesters (81%). Among those who do not strongly recommend the flu vaccine in the first trimester, many say this is because of their own concerns (28%) or their patients' concerns (44%) about safety. Older OB/GYNs, those in smaller practices, and those without academic affiliation were less likely to recommend the vaccine and more likely to have safety concerns. For example, 72% of those age 60+ strongly recommended the vaccine in the second and third trimester, compared with 86% of those ages 30-44 and 83% of those ages 45-59 ( < 0.05 for all comparisons). OB/GYNs across the country largely support seasonal flu vaccination among pregnant women. Nonetheless, safety is a concern for them and their patients. Outreach to support clinician decisions and conversations with pregnant patients may be most needed among older physicians, those in smaller practices, and those without academic affiliation.

摘要

孕妇季节性流感疫苗接种率仍远低于“健康人民 2020 年”目标的 80%。妇产科医生的建议是鼓励孕妇接种疫苗的重要手段,但关于他们的观点的数据有限。2015 年 10 月 26 日至 2016 年 5 月 8 日,对 506 名执业妇产科医生进行了全国代表性调查。分析包括使用全对、依赖检验,根据年龄、实践规模和学术隶属关系对单变量分布和比较。大多数妇产科医生报告说,他们“强烈建议”在第一个(79%)或第二个和第三个三个月(81%)为其孕妇患者接种季节性流感疫苗。在那些不强烈建议在第一个三个月接种流感疫苗的人当中,许多人表示这是因为他们自己(28%)或他们的患者(44%)对安全性的担忧。年龄较大的妇产科医生、规模较小的医生以及没有学术隶属关系的医生不太可能推荐疫苗,并且更有可能对安全性表示担忧。例如,72%的 60 岁以上的医生强烈建议在第二个和第三个三个月接种疫苗,而 44%的年龄在 30-44 岁的医生和 83%的年龄在 45-59 岁的医生强烈建议接种疫苗(所有比较均 < 0.05)。全国的妇产科医生普遍支持孕妇接种季节性流感疫苗。尽管如此,安全性仍然是他们和他们的患者关注的问题。支持临床医生决策和与孕妇进行对话的宣传工作可能在年龄较大的医生、规模较小的医生和没有学术隶属关系的医生中最为需要。

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