• Helen Ding, Katherine E Kahn, Carla L Black, Alissa O'Halloran, Peng-Jun Lu, and Walter W Williams.
• CFD Research Corporation, Huntsville, Alabama. Electronic address: hchding@gmail.com.
• Am J Prev Med. 2019 Apr 1; 56 (4): 477-486.

IntroductionPregnant women are at increased risk for severe illness from influenza and influenza-related complications. Vaccinating pregnant women is the primary strategy to protect them and their infants from influenza. This study aims to assess influenza vaccination coverage during three influenza seasons (2012-2015) from a national probability-based sampling survey and evaluate potential factors that influence vaccination uptake among pregnant women.MethodsData from the 2012 through 2015 National Health Interview Surveys were analyzed in 2017. Pregnant women aged 18-49 years were included in the analysis. The Kaplan-Meier survival analysis procedure was used for vaccination coverage in each season. Bivariate and multivariable logistic regression analyses were performed to examine factors associated with vaccination. Adjusted vaccination coverage and adjusted prevalence ratios are reported with corresponding 95% CIs.ResultsIn the 2012-2013, 2013-2014, and 2014-2015 influenza seasons, 40.4%, 45.4%, and 43.1% of pregnant women were vaccinated, respectively. Multivariable analysis indicated that factors independently associated with a lower likelihood of vaccination included having only a high school education, having three or less provider visits, and having no usual place of care (p<0.05). Less than half of women with ten or more visits were vaccinated (48.6%).ConclusionsVaccination coverage among pregnant women from this nationally representative sample was suboptimal during recent influenza seasons. Vaccination coverage was lower among certain sociodemographic, access-to-care subgroups. Multifactorial vaccination barriers may exist. Interventions, such as assessing vaccination history at every visit and implementing reminder-recall systems, standing orders, and addressing vaccination hesitancy, are needed to increase vaccination uptake among pregnant women.Copyright © 2018 American Journal of Preventive Medicine. All rights reserved.

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