A randomized controlled trial of an educational intervention to promote influenza vaccine uptake among pregnant women

Abstract

The purpose of this study was to evaluate the effectiveness of a brief education intervention on maternal influenza vaccine uptake. A total of 321 pregnant women were recruited from the antenatal clinics of four geographically distributed public hospitals in Hong Kong. Participants were randomized to receive either standard antenatal care or a one-to-one brief education session that provided an overview of the safety and benefits of the vaccine to pregnant women, the fetus, and the newborn baby. Participants were followed up by telephone at two weeks postpartum to ascertain vaccination status. The primary study outcome was receipt of influenza vaccination during pregnancy measured by maternal self-report at two weeks postpartum. Secondary study outcomes were the proportion of participants initiating discussion about influenza vaccine with their health care provider (HCP) and the proportion of unvaccinated participants who sought out the vaccine. When compared with participants who received standard care, the vaccination rate was higher among participants who received the intervention (21.1% vs. 10%; p=0.006). The number of participants who initiated discussion about influenza vaccination with their HCPs during pregnancy was also significantly higher in the intervention group (19.9% vs. 13.1%; p=0.01). Among those who did not receive influenza vaccine, 45 participants attempted to get vaccinated. When compared with the standard care group, a significantly higher proportion of participants in the intervention group attempted to get vaccinated (33.0% vs. 5.9%; p<0.001). Almost one-half of these participants (n=21; 46.7%) were advised against influenza vaccine by HCPs, including general practitioners, obstetricians, and nurses. If participants who had attempted to get vaccinated had received the vaccine, the vaccination rates would have been even higher in both groups (29.2% vs. 15.0%; p=0.002). Although brief education was effective in improving vaccination uptake among pregnant women, overall vaccination rates remain suboptimal. Multicomponent approaches, including providing positive HCP vaccination recommendations, should be used to promote maternal influenza vaccination.