Zhang Yuanyuan, Hong Wanting, Wang Rui, Bao Lin, Liu Cheng, Cui Pengwei, Tan Yayun, Hang Hui, Pang Yuanyuan, Xu Qian, Tian Ge, Jiang Jiarun, Zhang Suping, Chen Liling
School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Suzhou Center for Disease Control and Prevention, Suzhou 215123, China.
Vaccines (Basel). 2025 May 30;13(6):589. doi: 10.3390/vaccines13060589.
Health departments disseminate health education related to influenza to the public through various media in China. We examined knowledge, attitudes, and practices regarding influenza and the influenza vaccine (KAP-flu) over time among pregnant women (PW) compared to non-PW.
A cross-sectional survey was conducted in Suzhou, China in 2013 and 2023. We included and interviewed PW seeking prenatal care and excluded PW there for non-routine visits. The comparison group was drawn from non-PW seeking physical examinations at the same facilities. Stratified cluster sampling was used to enroll participants from the various levels of prenatal-care facilities.
In 2013, we surveyed 1673 PW and 401 non-PW, and in 2023, we surveyed 2195 PW and 1171 non-PW. The proportion of PW who had ever heard of the influenza vaccine showed no significant change, at 56% in 2013 and 57% in 2023; by contrast, there was a significant increase among non-PW (55% to 78%). The proportion of pregnant participants who knew when to get vaccinated dropped from 14% to 12%, in contrast to the increase among non-PW (6% to 20%). The proportion of PW who believed that the influenza vaccine is effective dropped from 91% in 2013 to 76% in 2023, in contrast to the stable value among non-PW (84% to 82%). In 2023, pregnant participants exhibited lower levels of knowledge about both influenza disease and the influenza vaccine, along with less positive attitudes toward the effectiveness and safety of the vaccine. They also showed lower willingness to vaccinate and lower vaccination rates compared to non-pregnant participants. Concerning KAP-flu among PW, less than half recognized that influenza is different from a common cold; fewer than one in five understood the timing and frequency of vaccination or the policy prioritizing PW for influenza vaccination; vaccination coverage remained below 2% over time.
PW had concerning gaps in knowledge and attitudes regarding influenza and the influenza vaccine compared to non-PW in Suzhou, China. Specific actions targeting PW, such as initiatives leveraging the maternal and child healthcare system, are warranted to reduce the gaps.
在中国，卫生部门通过各种媒体向公众传播与流感相关的健康教育内容。我们比较了孕妇与非孕妇在不同时间点对流感及流感疫苗的知识、态度和行为（KAP-flu）。
2013年和2023年在中国苏州进行了一项横断面调查。我们纳入并采访了寻求产前护理的孕妇，排除因非例行就诊而来的孕妇。对照组来自在同一机构进行体检的非孕妇。采用分层整群抽样从各级产前护理机构招募参与者。
2013年，我们调查了1673名孕妇和401名非孕妇，2023年，我们调查了2195名孕妇和1171名非孕妇。曾经听说过流感疫苗的孕妇比例无显著变化，2013年为56%，2023年为57%；相比之下，非孕妇中的这一比例显著上升（从55%升至78%）。知道何时接种疫苗的孕妇比例从14%降至12%，而非孕妇中的这一比例有所上升（从6%升至20%）。认为流感疫苗有效的孕妇比例从2013年的91%降至2023年的76%，而非孕妇中的这一比例保持稳定（从84%降至82%）。2023年，孕妇对流感疾病和流感疫苗的知识水平较低，对疫苗有效性和安全性的态度也不那么积极。与非孕妇相比，她们接种疫苗的意愿和接种率也较低。关于孕妇的KAP-flu，不到一半的人认识到流感与普通感冒不同；不到五分之一的人了解接种疫苗的时间和频率或优先为孕妇接种流感疫苗的政策；随着时间的推移，疫苗接种覆盖率仍低于2%。
在中国苏州，与非孕妇相比，孕妇在流感及流感疫苗的知识和态度方面存在令人担忧的差距。有必要采取针对孕妇的具体行动，例如利用妇幼保健系统开展相关举措，以缩小差距。
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