Evaluating Factors That Influence Influenza Vaccination Uptake among Pregnant People in a Medically Underserved Area in Washington State
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study and Research Tool Design
2.2. Participants and Data Collection
2.3. Data Analysis
2.4. Ethical Considerations
3. Results
3.1. Demographics
3.2. Evaluating the Relationship between Vaccination and Pregnancy
3.3. Evaluating the Relationship between Pregnancy, Vaccination, and Trust in Medical Care
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Survey Question Number | Survey Question | Topic Domain |
---|---|---|
1 | Have you lived in Yakima County for the past 12 months or longer? | Inclusion criteria |
2 | Are you age 18 or older? | Inclusion criteria |
3 | Have you ever been pregnant? | Inclusion criteria |
4 | Please indicate your ethnicity: Latino/Latina//Hispanic; Non-Hispanic. | Demographics |
5 | Please indicate your race: white or Caucasian; Black or African American; Asian; Native Hawaiian or Other Pacific Islander; American Indian/Alaska Native/Tribal; Other, please specify. | Demographics |
6 | What is the highest level of education you have completed: less than high school; high school or GED; some college/AA degree/technical certificate; bachelors degree; advanced degree (PhD, Masters, MD, etc.); other, please specify. | Demographics |
7 | Which of the following categories best describes your current employment status? | Demographics |
8 | Which of the following categories best describes who you work for? | Demographics |
9 | Which of the following is your age group? | Demographics |
10 | Have you ever served in any branch of the United States military? | Demographics |
11 | Which one of the following best describes your current marital status? | Demographics |
12 | Which gender do you identify as? | Demographics |
13 | Did you get the flu vaccine during your pregnancy or when you were trying to become pregnant? | Pregnancy and vaccination |
14A | If you answered “yes” to the previous question, how important were each of the following reasons for you to get vaccinated against the flu: protect yourself from the flu, protect your family/friends from the flu; protect your community from the flu; your employer encouraged you to get vaccinated; your employer mandated that you get vaccinated; your family/friend encouraged you to get vaccinated; a healthcare provider encouraged you to get vaccinated; it was convenient; it was available for free or low cost; or other (please describe). | Pregnancy and vaccination |
14B | If you answered “no” to the previous question, how important were each of the following reasons for you to choose not to get vaccinated against the flu in the past 5 years: Getting the vaccine is inconvenient; I do not believe the vaccine works; I am allergic to the vaccine; Religious reasons; I was worried about the side effects; or other (please describe) | Pregnancy and vaccination |
15 | How often in the past five years have you been vaccinated for the flu? | Influenza vaccination status |
16 | Are you up to date on all your routine vaccinations? Routine vaccinations include vaccines like pneumonia, hepatitis, measles, and tetanus, but does not include COVID-19 or flu vaccine. | Routine vaccination status |
17 | Will you continue to be vaccinated with routine vaccines? | Routine vaccination status |
18 | If you answered “no” to the previous question, why not? (open ended response field) | Routine vaccination status |
19 | Do you have an egg allergy? | Routine vaccination status |
20 | If you are up to date on all your routine vaccinations but answered “no” to “Will you continued to be vaccinated with routine vaccines”, please explain why not. | Routine vaccination status |
21 | How much do you trust the advice of each of the following healthcare providers: primary care provider, specialty care provider, pharmacist, nurse, other (please list). | Healthcare provider trust and advice |
22 | Was getting the flu vaccine during pregnancy recommended by your healthcare provider? | Healthcare provider trust and advice |
23 | How confident are you that you have received good information about the flu vaccine? | Vaccination confidence |
24 | How confident are you that the flu vaccine is safe? | Vaccination confidence |
25 | How confident are you in your knowledge of how the flu vaccine works? | Vaccination confidence |
Demographic | Number | Percentage |
---|---|---|
Age (n = 244) | ||
18–24 years | 2 | 0.6% |
25–34 years | 24 | 9.9% |
35–44 years | 45 | 18.6% |
45–54 years | 61 | 24.9% |
55–64 years | 64 | 26.1% |
65–79 years | 34 | 14.1% |
80 years or older | 14 | 5.7% |
Race (n = 244, multiple response possible) | ||
White or Caucasian | 204 | 83.6% |
American Indian/Alaska Native/Tribal | 11 | 4.5% |
Asian | 5 | 2.0% |
Black or African American | 5 | 2.0% |
Native Hawaiian or Other Pacific Islander | 2 | 0.8% |
Other (Mexican, Hispanic) | 14 | 5.7% |
Ethnicity (n = 228) | ||
Latino/Latina/Hispanic | 54 | 23.8% |
Non-Hispanic | 174 | 76.2% |
Highest level of education completed (n = 239) | ||
Less than high school | 12 | 5.1% |
High school or GED | 45 | 19.0% |
Some college/AA degree/technical certificate | 83 | 34.6% |
Bachelor’s degree | 60 | 25.0% |
Advanced degree (Masters, PhD, MD, etc.) | 37 | 15.3% |
Other (multiple degrees) | 2 | 1.0% |
Current marital status (n = 245) | ||
Married | 150 | 61.4% |
Living with a partner | 14 | 5.6% |
Never married | 13 | 5.1% |
Divorced or separated | 42 | 17.4% |
Widowed | 23 | 9.3% |
Other (single, living alone, married but living separately) | 3 | 1.1% |
Employment status (n = 241) | ||
Employed full-time | 136 | 56.8% |
Employed part-time | 19 | 7.9% |
Not employed, looking for employment | 2 | 0.6% |
Not employed, not looking for employment | 26 | 10.7% |
Retired | 58 | 24.0% |
Employment Category for those employed (n = 155) | ||
Private, for-profit company or business, or for an individual | 61 | 39.6% |
Private not-for-profit, tax-exempt, or charitable organization | 13 | 8.1% |
Local government (city, county, etc.) | 15 | 9.8% |
State government | 33 | 21.2% |
Federal government | 0 | 0.3% |
Self-employed in my own NOT incorporated business, professional practice, or farm | 14 | 8.9% |
Self-employed in my own incorporated business, professional practice, or farm | 8 | 5.2% |
Working without pay in family business or farm | 2 | 1.0% |
Other (healthcare, higher education, school district) | 9 | 5.9% |
Ever served in the United States military (n = 243) | ||
Yes, now on active duty | 0 | 0.0% |
Yes, on active duty in the p0.0ast, but not in last 12 months | 6 | 2.6% |
No, training for Reserves or National Guard only | 0 | 0.0% |
No, never served in the military | 237 | 97.4% |
Theme | Illustrative Quote |
---|---|
Belief that vaccination was not needed. | “I was young and never really got sick that much”. “The flu vaccine was not important to me at that time”. “I don’t need a flu vaccine, we get the flu every test whether we are vaccinated for the flu or not”. “I didn’t feel I was at risk”. |
Lack of awareness or recommendation. | “Was younger and I did not know much about flu vaccine”. “It was never offered to me by my doctors”. “Never heard of any flu vaccine given at that time of pregnancies”. |
Lack of access to the influenza vaccine. | “I don’t recall a flu vaccine being available when I was pregnant in the early 1980′s”. “Lived remote in Alaska”. “I don’t believe it was available” |
Did not want to be vaccinated against influenza. | “I’ve never gotten a flu shot! Never wanted to”. “Felt that it would be ok if I got [the flu], and my body would fight it”. “Never ever believed in the flu vaccine”. |
Concerned about safety of vaccination during pregnancy. | “I didn’t take any Rx then or want to jeopardize pregnancy viability”. “Was afraid of what it might do to my babies”. “I did not want to risk adverse side effects to the fetus”. “Too many side effects that could harm a baby”. “I wasn’t going to put foreign chemicals in my child”. |
How Much Do You Trust the Advice of Each of the following Healthcare Providers? (Question 21) | Not at All | Only a Little | Mostly | Strongly |
---|---|---|---|---|
Primary care provider (n = 241) | 3.8% | 10.3% | 46.5 | 39.9% |
Specialty care provider (cardiologist, pulmonologist, etc.) (n = 219) | 8.0% | 6.8% | 43.4% | 41.8% |
Pharmacist (n = 229) | 6.1% | 16.0% | 45.9% | 31.9% |
Nurse (n = 228) | 23.8% | 46.7% | 29.5% |
Survey Question | Not at All Confident | Only a Little Confident | Mostly Confident | Very Confident |
---|---|---|---|---|
How confident are you that you have received good information about flu vaccines? (Question 23, n = 241) | 8.9% | 13.5% | 47.7% | 30.0% |
How confident are you in your knowledge of how the flu vaccine works? (Question 24, n = 241) | 8.9% | 19.6% | 48.7% | 23.8% |
How confident are you that flu vaccine is safe? (Question 25, n = 242) | 15.4% | 14.1% | 40.9% | 29.6% |
Frequency of Being Vaccinated against Influenza in the Last 5 Years Question 15 (n = 238) | Number | Percentage |
---|---|---|
Not at all | 75 | 31.6% |
1–2 times | 34 | 14.4% |
3–4 times | 36 | 15.1% |
Every year | 93 | 38.9% |
Survey Item | Received Influenza Vaccine during Pregnancy or When Trying to Become Pregnant (Question 13) | Total | |||||
---|---|---|---|---|---|---|---|
Yes | No | ||||||
Number | Percentage | Number | Percentage | Number | Percentage | ||
Are you up to date on all your routine vaccinations? (Question 16) (n = 227) | Yes | 69 | 88.5% | 114 | 76.5% | 183 | 80.6% |
No | 9 | 11.5% | 35 | 23.5% | 44 | 19.4% | |
Will you continue to be vaccinated with routine vaccines? (Question 17) (n = 193) | Yes | 68 | 95.8% | 104 | 85.2% | 172 | 89.1% |
No | 3 | 4.2% | 18 | 14.8% | 21 | 10.9% |
Received Influenza Vaccine during Pregnancy or When Trying to Become Pregnant (Question 13) | Total | ||||||
---|---|---|---|---|---|---|---|
Yes | No | ||||||
Number | Percentage | Number | Percentage | Number | Percentage | ||
Frequency of getting flu vaccine within the past five years (Question 15) | Not at all | 13 | 16.7% | 60 | 40.0% | 73 | 32.0% |
1–2 times | 6 | 7.7% | 28 | 18.7% | 34 | 14.9% | |
3–4 time | 25 | 32.1% | 11 | 7.3% | 36 | 15.8% | |
Every time | 34 | 43.6% | 51 | 34.0% | 85 | 37.3% | |
Total | 78 | 100.0% | 150 | 100.0% | 228 | 100.0% |
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Share and Cite
McKeirnan, K.; Brand, D.; Giruzzi, M.; Vaitla, K.; Giruzzi, N.; Krebill-Prather, R.; Dang, J. Evaluating Factors That Influence Influenza Vaccination Uptake among Pregnant People in a Medically Underserved Area in Washington State. Vaccines 2024, 12, 768. https://doi.org/10.3390/vaccines12070768
McKeirnan K, Brand D, Giruzzi M, Vaitla K, Giruzzi N, Krebill-Prather R, Dang J. Evaluating Factors That Influence Influenza Vaccination Uptake among Pregnant People in a Medically Underserved Area in Washington State. Vaccines. 2024; 12(7):768. https://doi.org/10.3390/vaccines12070768
Chicago/Turabian StyleMcKeirnan, Kimberly, Damianne Brand, Megan Giruzzi, Kavya Vaitla, Nick Giruzzi, Rose Krebill-Prather, and Juliet Dang. 2024. "Evaluating Factors That Influence Influenza Vaccination Uptake among Pregnant People in a Medically Underserved Area in Washington State" Vaccines 12, no. 7: 768. https://doi.org/10.3390/vaccines12070768
APA StyleMcKeirnan, K., Brand, D., Giruzzi, M., Vaitla, K., Giruzzi, N., Krebill-Prather, R., & Dang, J. (2024). Evaluating Factors That Influence Influenza Vaccination Uptake among Pregnant People in a Medically Underserved Area in Washington State. Vaccines, 12(7), 768. https://doi.org/10.3390/vaccines12070768