Epidemiologic Reviews Advance Access originally published online on May 26, 2006
Epidemiologic Reviews 2006 28(1):47-53; doi:10.1093/epirev/mxj002
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Delivering Influenza Vaccine to Pregnant Women
1 Center for Health Research, Kaiser Permanente Northwest, Portland, OR
2 Department of Obstetrics and Gynecology, Kaiser Permanente Northwest, Portland, OR
Correspondence to Dr. Allison Naleway, Center for Health Research, Kaiser Permanente Northwest, 3800 North Interstate Avenue, Portland, OR 97227 (e-mail: allison.naleway{at}kpchr.org).
accepted for publication March 27, 2006.
Pregnant women have an increased risk of influenza infection and complications. The Advisory Committee on Immunization Practices currently recommends vaccination for women who are pregnant during influenza season. The authors review the literature concerning influenza vaccine safety, effectiveness, and coverage rates during pregnancy, as well as opportunities to improve vaccination rates during pregnancy. No study has demonstrated an increased risk of maternal complications or adverse fetal outcomes associated with inactivated influenza vaccine. Few studies have examined the effectiveness of vaccination during pregnancy, and the results from these studies are inconsistent, with some showing a protective effect and others showing no effect. Despite the proven safety of vaccination and the possible benefits to women and their infants, reported vaccination rates during pregnancy are generally less than 10%. Mothers frequently cite concerns about vaccine safety as a barrier to vaccination. Lack of adequate information about the risks and benefits of vaccination is reported by both patients and obstetric care providers. Organizational factors such as lack of vaccine storage facilities may also limit vaccination during pregnancy. Effective interventions should target factors pertaining to patients or providers, or they should address organizational or logistic barriers. The Advisory Committee on Immunization Practices currently recommends standing orders programs or reminders for patients and providers as strategies to improve vaccination rates.
influenza, human • pregnancy • vaccination
ACIP, Advisory Committee on Immunization Practices
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