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Obstetric Health Care Workers’ Attitudes and Beliefs Regarding Influenza Vaccination in Pregnancy

Broughton, D E.1; Beigi, R H. MD, MSCR2; Switzer, G E. PhD3; Raker, C A. ScD1; Anderson, B L. MD, MSCR1

doi: 10.1097/AOG.0b013e3181bd89c2
Original Research

OBJECTIVE: To explore obstetric health care workers’ attitudes and beliefs regarding influenza vaccination in pregnancy.

METHODS: A survey consisting of 16 multiple-choice questions was administered to nurses, medical and nursing assistants, receptionists, and clinical administrators in obstetric settings. Survey questions addressed general knowledge of influenza and recommendations for vaccination during pregnancy, as well as personal beliefs about the acceptability of the vaccine in the pregnant population. The study was conducted at two sites, Women & Infants Hospital in Providence, RI, and Magee-Women’s Hospital in Pittsburgh, PA. Variables were compared by Fisher exact test.

RESULTS: Two hundred sixty-seven completed surveys were available for analysis, with a completion rate of 85%. Almost one third of health care workers surveyed do not believe that vaccines are a safe and effective way to decrease infections (31%) and a minority believe that vaccines are safe in pregnancy (36%). Just over half of health care workers know that pregnant women are at increased risk of complications from the flu (56.6%). Only 46% were able to correctly identify influenza symptoms, and only 65% would recommend influenza vaccination to a pregnant woman if indicated. A small percentage would be willing to give an avian influenza vaccine to pregnant women during a pandemic if it had not been tested in pregnancy (12.3%).

CONCLUSION: Many obstetric health care workers lack knowledge regarding the safety and importance of influenza vaccination during pregnancy. Misinformed or inadequately informed health care workers may represent a barrier to influenza vaccine coverage of pregnant women. This lack of knowledge among the health care workforce takes on added importance in the setting of the H1N1 2009 swine-origin influenza pandemic.


Many obstetric health care workers lack knowledge regarding the safety and importance of influenza vaccination during pregnancy.

From the 1Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Women & Infants Hospital, Providence, Rhode Island; 2Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh and Magee-Women’s Hospital, Pittsburgh, Pennsylvania; and 3Departments of Medicine and Psychiatry, University of Pittsburgh School of Medicine, Center for Health Equity and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.

Sources of Funding: 1) Alpert Medical School Scholarly Concentration in Women’s Reproductive Health, Freedom & Rights; 2) Brown University Women’s Reproductive Health Research scholar program, 5K12-HD050108-04; and 3) Departmental funding: Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Women’s Hospital of the University of Pittsburgh Medical Center

Portions of the data were presented as a poster at the 2009 Annual Meeting of the American College of Obstetricians and Gynecologists, May 4–6, 2009, Chicago, Illinois.

Corresponding author: Darcy E. Broughton, BA, MS3, Alpert Medical School of Brown University, Box 8191, 75 Waterman Street, Providence, RI 02912; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2009 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.