• Surasak Kaoiean, Wanitchaya Kittikraisak, Piyarat Suntarattiwong, Darunee Ditsungnoen, Podjanee Phadungkiatwatana, Nattinee Srisantiroj, Suvanna Asavapiriyanont, Tawee Chotpitayasunondh, Fatimah S Dawood, and Kim A Lindblade.
• Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand.
• Influenza Other Respi Viruses. 2019 Nov 1; 13 (6): 582-592.

BackgroundPhysician recommendation and attitudes and beliefs of pregnant women toward influenza and vaccination may influence vaccine uptake during pregnancy. We examined how physician recommendation and health beliefs of pregnant women may jointly affect influenza vaccination during pregnancy.MethodsThai pregnant women aged ≥18 years and >13 gestational weeks attending antenatal care (ANC) clinics, and ANC physicians were recruited during May-August 2015. Women and physicians, linked using unique identifiers, provided data on demographic, health and work history, knowledge, attitudes, and beliefs toward influenza and vaccination, based on Health Belief Model constructs. Physicians also provided data on their practices in recommending influenza vaccination during pregnancy. Prevalence ratios for the association between knowledge, attitudes and beliefs of pregnant women, physician recommendation and documented receipt of vaccination within 30 days of the visit were calculated.ResultsAmong 610 women, the median age was 27 years; 266 (44%) and 344 (56%) were in the second and third trimesters, respectively. Twenty-one (3%) had pre-existing conditions. Of 60 physicians with the median years of practice of 5; 17 (28%) reported frequently/usually/always recommending influenza vaccine to their pregnant patients, while 43 (72%) reported never/rarely/sometimes recommending the vaccine. Controlling for the pregnant women's knowledge and beliefs, pregnant women whose physician recommended influenza vaccination were 2.3 times (95% confidence interval 1.4-3.8) more likely to get vaccinated.ConclusionsIn this study, physician recommendation was the only significant factor associated with influenza vaccine uptake among Thai pregnant women. Understanding physicians' motivation/barrier to recommending influenza vaccination to pregnant women may increase coverage.© 2019 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

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