Predictors of seasonal influenza vaccination during pregnancy

Obstet Gynecol. 2013 Apr;121(4):741-749. doi: 10.1097/AOG.0b013e3182878a5a.


Objective: Although pregnant women are a high-priority group for influenza vaccination, vaccination rates in this population remain below recommended levels. This prospective cohort study followed a group of pregnant women during the 2010-2011 influenza season to determine possible predictors of vaccination.

Methods: Participants were 552 pregnant women who had not already received the influenza vaccine at the time of enrollment. Women completed a survey assessing knowledge, attitudes, and beliefs about vaccination (based on the Health Belief Model) by telephone and were then followed to determine vaccination status by the end of the 2010-2011 influenza season.

Results: Forty-six percent (n=252) of the women were vaccinated, and 54% (n=300) remained unvaccinated after enrollment in the study. Few baseline characteristics, with the exception of study site, month of enrollment, and maternal ethnicity, were predictive of vaccination status. Even after adjusting for significant baseline characteristics, we found that at least one item from each domain of the Health Beliefs Model was predictive of subsequent vaccination. Specifically, women who perceived they were susceptible to influenza, that they were at risk of getting seriously ill from influenza, that they would regret not getting vaccinated, and who trusted recommended guidelines about influenza vaccination during pregnancy were more likely to get vaccinated. Women who were concerned about vaccine side effects were less likely to get vaccinated.

Conclusion: Trust in recommendations, perceived susceptibility to and seriousness of influenza, perceived regret about not getting vaccinated, and vaccine safety concerns predict vaccination in pregnant women.

Level of evidence: II.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Female
  • Forecasting
  • Humans
  • Influenza Vaccines*
  • Influenza, Human / prevention & control*
  • Pregnancy
  • Pregnancy Complications, Infectious / prevention & control*
  • Prospective Studies
  • Vaccination / statistics & numerical data*
  • Young Adult


  • Influenza Vaccines