Massachusetts Increases Influenza Vaccinations Among Pregnant Women During H1N1

May 28, 2015|10:22 a.m.| ASTHO Staff

During the 2009 H1N1 influenza outbreak, the Massachusetts Department of Public Health (MADPH) identified a significantly higher hospitalization rate among pregnant women: 41 percent compared to 7 percent of all confirmed cases. After observing this rate, MADPH partnered with the Massachusetts chapter of the American College of Obstetrician Gynecologists (MAACOG) to increase influenza vaccinations and prompt treatment for pregnant women, particularly those who also belonged to minority populations. MADPH and MAACOG then issued a joint clinical advisory  recommending that obstetrical providers exercise increased vigilance by closely monitoring any pregnant patients with flu symptoms and modifying their clinical assessments and treatment protocols to ensure rapid initiation of antiviral therapy.

MADPH’s Immunization Program and MAACOG connected with providers and identified barriers to immunization among obstetric providers. Women cited several reasons why they did not get a flu shot, including concerns about side effects for themselves or their babies, not thinking that they were at risk for getting the flu, and doctors not mentioning the need for vaccination. Through radio, TV, and print advertising in 10 different languages, MADPH alerted the public about how important it is for pregnant women to get vaccinated.

MADPH gathered information on flu vaccination acceptance, barriers, and predictors through its Pregnancy Risk Assessment Monitory Survey during the 2009-2010 and 2010-2011 flu seasons. The results highlight the key role that obstetrical providers can play in promoting flu vaccination among pregnant women, showing improvements in flu vaccination disparities by ethnicity, education, and insurance status. After the MADPH and MAACOG initiative, fewer women who did not receive the flu shot reported that it was because their doctor did not mention it (21 percent in 2010-2011 versus 29 percent in 2009-2010).

It is important to educate both pregnant women and obstetric providers about the importance and safety of vaccination during pregnancy. Successfully increasing flu vaccinations among pregnant women in Massachusetts required the coordinated efforts of multiple MADPH bureaus, including infectious disease, family health and nutrition, and communications. The ensuing improved communication and interaction between obstetric providers resulted in sustained increases in the number of these providers who participate in the state’s vaccine distribution program. Public health departments can encourage obstetrical providers to strongly recommend vaccination to pregnant women and their families.

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