Determinants of A (H1N1) vaccination: Cross-sectional study in a population of pregnant women in Quebec

Background: Because of the risk of complication, pregnant women were a priority target for vaccination during the A (H1N1) pandemic influenza. In Quebec, 63% of pregnant women were vaccinated, which is a higher rate than vaccination against seasonal influenza. However, the behaviour of pregnant women relative to the vaccination during the H1N1 pandemic is unknown. The present study was aimed at identifying factors influencing the decision-making of pregnant women regarding Hi NI vaccination. Methods: A cross-sectional survey was conducted in February 2010 in pregnant women or in early postpartum at the Sherbrooke University Hospital Centre using a self-administered questionnaire based on the Health Belief Model (HBM). Data items collected were: socio-demographic data, vaccination status, information sources consulted, knowledge on vaccination, and the HBM dimensions: effectiveness and risks of vaccination, severity and vulnerability towards the influenza. The associations between questionnaire variables and vaccination status were assessed by univariate and multivariate analysis. Results: Of the 250 women interviewed, 95% knew that the vaccination was recommended, but only 76% received the vaccine. Variables positively associated with vaccination were late vaccination during pregnancy (OR = 7.3, 95% CI 2.1-25.3), belief in the efficacy of the vaccine (OR = 7, 95% CI 2-23.4), and consultation of the Pandemie-Quebec website (OR = 4.5, 95% CI 1.5-13.4). However, the belief that the vaccine had not been adequately tested (OR = 0.08, 95% CI 0.02-0.35) and consultation of mainstream websites (OR = 0.22, 95% CI 0.06-0.81) were associated with lower vaccination rates. Conclusions: The vast majority of pregnant women were aware of the recommendations relative to A (H1N1) vaccination. Internet media played an important role in their decision to get vaccinated. Better information on the safety of the vaccine must be prepared for future pandemics. (C) 2011 Elsevier Ltd. All rights reserved.