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ATİKEL YÖ, BAKKALOĞLU SA, PAGLIALONGA F, STEFANIDIS CJ, ASKITI V, VIDAL E, ARICETA G, MELEK E, VERRINA E, PRINTZA N, VONDRAK K, ZUROWSKA A, ZAGOZDZON I, EKİM M, ÖZMERT EN, DUFEK S, JANKAUSKIENE A, SCHMITT CP, LÉVAI E, WALLE JV, CANPOLAT N, HOLTTA T, FISCHBACH M, ZALOSZYC A, KLAUS G, AUFRICHT C, SHROFF R, EDEFONTI A. Influenza and pneumococcus vaccination rates in pediatric dialysis patients in
Europe: recommendations vs reality A European Pediatric Dialysis Working Group and European Society for Pediatric Nephrology Dialysis Working Group study. Turk J Med Sci 2021; 51:2881-2886. [PMID: 33535736 PMCID: PMC10734874 DOI: 10.3906/sag-2012-26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/13/2021] [Accepted: 02/03/2021] [Indexed: 11/03/2022] Open
Abstract
Background/aim Children on dialysis are under increased risk of influenza and invasive pneumococcal disease. Although vaccination against these microorganisms are recommended in dialysis patients and despite the fact that these vaccines can reduce disease burden and rates of hospitalization due to infection, vaccination rates are below expected and desired. We aimed to evaluate influenza and pneumococcal vaccination and infection rates in European pediatric dialysis centers. Materials and methods In 16 centers from 11 countries, 357 pediatric dialysis patients were evaluated retrospectively during 1 year of observation period between 01.01.2014 and 01.01.2015. Results In all centers, vaccination policy included immunization of dialysis patients with inactive influenza vaccine and pneumococcal conjugate vaccine (PCV). Fifty percent of the centers recommended pneumococcal polysaccharide vaccine following routine PCV series. A significantly higher pneumococcal vaccination rate (43.9%) was seen in peritoneal dialysis (PD) patients compared to those on hemodialysis (HD) (32.9%) (p = 0.035), while the rates for influenza were similar (42.4% and 46.1% respectively, p = 0.496). Among all dialysis patients, 2.2% (n = 8) developed pneumonia and 6.4% (n = 23) was infected by Influenza. Pneumococcic pneumonia rate was 5% for 140 patients who received antipneumococcal vaccine, while only one pneumonia episode was recorded out of 217 unvaccinated patients (p = 0.007). The influenza virus infection rates were similar for patients vaccinated and nonvaccinated (7 % and 6 %, respectively). Conclusions Although influenza and pneumococcal vaccines are highly recommended in pediatric dialysis patients, vaccination rates were lower than expected. Pneumococcal vaccination rates were higher in PD compared to the patients on HD. The rate of children with influenza infection was higher than pneumonia. The efficacy of influenza and pneumococcal vaccines was highlighted by the low infection rates. Higher pneumonia rates in patients vaccinated against pneumococcus compared to unvaccinated ones might be due to coexisting risk factors.
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Affiliation(s)
- Yeşim Özdemir ATİKEL
- Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara,
Turkey
| | - Sevcan A BAKKALOĞLU
- Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara,
Turkey
| | - Fabio PAGLIALONGA
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan,
Italy
| | | | - Varvara ASKITI
- Department of Pediatric Nephrology, A. and P. Kyriakou Children’s Hospital, Athens,
Greece
| | - Enrico VIDAL
- Department of Pediatric Nephrology, Faculty of Medicine, Padova University, Padova,
Italy
| | - Gema ARICETA
- Department of Pediatric Nephrology, University Hospital Vall d’ Hebron, Barcelona,
Spain
| | - Engin MELEK
- Department of Pediatric Nephrology, Faculty of Medicine, Çukurova University, Adana,
Turkey
| | - Enrico VERRINA
- Dialysis Unit, Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genoa,
Italy
| | - Nikoleta PRINTZA
- 1st Pediatric Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloníki,
Greece
| | - Karel VONDRAK
- Department of Pediatric Nephrology, Faculty of Medicine, University Hospital Motol, Prague,
Czech Republic
| | - Aleksandra ZUROWSKA
- Department of Pediatrics Nephrology & Hypertension, Medical University of Gdansk, Gdansk,
Poland
| | - Ilona ZAGOZDZON
- Department of Pediatrics Nephrology & Hypertension, Medical University of Gdansk, Gdansk,
Poland
| | - Mesiha EKİM
- Department of Pediatric Nephrology, Faculty of Medicine, Ankara University, Ankara,
Turkey
| | - Elif Nursel ÖZMERT
- Department of Social Pediatrics, Faculty of Medicine, Hacettepe University, Ankara,
Turkey
| | - Stephanie DUFEK
- Department of Pediatric Nephrology, Great Ormond Street Hospital for Children, London,
UK
| | - Augustina JANKAUSKIENE
- Pediatric Center, Institute of Clinical Medicine, Vilnius University, Vilnius,
Lithuania
| | - Claus Peter SCHMITT
- Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg,
Germany
| | - Eszter LÉVAI
- Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg,
Germany
| | - Johan Vande WALLE
- Department of Pediatric Nephrology, Utoped, Universitair Ziekenhuis Gent, Ghent,
Belgium
| | - Nur CANPOLAT
- Department of Pediatric Nephrology, Cerrahpaşa Medical School, İstanbul,
Turkey
| | - Tuula HOLTTA
- Department of Pediatric Nephrology, Faculty of Medicine, University of Helsinki, Helsinki,
Finland
| | - Michel FISCHBACH
- Department of Pediatric Nephrology, Hopital de Hautepierre, Strasbourg,
France
| | - Ariane ZALOSZYC
- Department of Pediatric Nephrology, Hopital de Hautepierre, Strasbourg,
France
| | - Guenter KLAUS
- Department of Pediatric Nephrology, KfH Children’s Kidney Center, Marburg,
Germany
| | - Christoph AUFRICHT
- Department of Pediatric Nephrology, Medical University of Vienna, Vienna,
Austria
| | - Rukshana SHROFF
- Department of Pediatric Nephrology, Great Ormond Street Hospital for Children, London,
UK
| | - Alberto EDEFONTI
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan,
Italy
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2
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Bettinger JA, Rouleau I, Gariépy MC, Bowie WR, Valiquette L, Vanderkooi OG, Kellner JD, Coleman BL, McNeil SA, McCarthy A, De Serres G. Successful methodology for large-scale surveillance of severe events following influenza vaccination in Canada, 2011 and 2012. Euro Surveill 2015; 20:21189. [DOI: 10.2807/1560-7917.es2015.20.29.21189] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - I Rouleau
- Centre de Recherche du CHU de Québec, Laval University, Canada
| | - M C Gariépy
- Centre de Recherche du CHU de Québec, Laval University, Canada
| | - W R Bowie
- Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - L Valiquette
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - O G Vanderkooi
- Alberta Children’s Hospital, University of Calgary, Calgary, Alberta, Canada
| | - J D Kellner
- Alberta Children’s Hospital, University of Calgary, Calgary, Alberta, Canada
| | - B L Coleman
- Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - S A McNeil
- Canadian Center for Vaccinology, IWK Health Centre, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada
| | - A McCarthy
- Ottawa Hospital, Ottawa, Ontario, Canada
| | - G De Serres
- Centre de Recherche du CHU de Québec, Laval University, Canada
- Institut National de Santé Publique du Quebec, Quebec City, Quebec, Canada
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Vaccinating high-risk children with the intranasal live-attenuated influenza vaccine: the Quebec experience. Paediatr Respir Rev 2014; 15:340-7. [PMID: 25242731 DOI: 10.1016/j.prrv.2014.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 06/17/2014] [Indexed: 11/21/2022]
Abstract
UNLABELLED Given the burden of illness associated with influenza, vaccination is recommended for individuals at high risk of complications. The live-attenuated influenza vaccine (LAIV) is administered by intranasal spray, thus directly stimulating mucosal immunity. In this review, we aimed to provide evidence for its efficacy and safety in different paediatric populations. We also share the Quebec experience of LAIV use through a publicly funded vaccination program for children with chronic, high-risk conditions. RESULTS from randomized controlled trials in healthy children and in asthmatics have demonstrated superior efficacy of LAIV over the injectable vaccine (IIV). LAIV is well tolerated: its administration is associated with runny nose and nasal congestion, but not with asthma exacerbations and is well tolerated in children with cystic fibrosis, when compared to IIV. The vaccine is well accepted by children and parents and can easily be part of vaccination clinics in paediatric tertiary care centres targeting children with chronic, high-risk conditions, not leading to immunosuppression.
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4
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Abstract
Influenza is a highly infectious respiratory disease that can impose significant health risks leading to increased morbidity and mortality. Receiving influenza vaccination is the most important and effective means of preventing the infection and its related complications. During pregnancy, physiological changes increase susceptibility to influenza infection, and women contracting infectious diseases during pregnancy are more likely to have adverse pregnancy and neonatal outcomes. Influenza vaccination during pregnancy is safe for both pregnant women and their fetus, and pregnant women are now the highest priority group for vaccination. Despite the accumulated evidence of the benefits and safety of influenza vaccination during pregnancy, uptake among pregnant women remains suboptimal. Concerns about the vaccine's safety persist, and the fear of birth defects remains the predominant barrier to vaccination. Targeted interventions have been shown effective in enhancing influenza vaccination uptake among pregnant women. Reluctance to be vaccinated should be addressed by offering accurate information to counteract the misperceptions about the risk of influenza infection during pregnancy as well as to educate mothers about the safety and benefits of influenza vaccination. High-quality randomized controlled trials are recommended to evaluate the effectiveness of individual or multifaceted approaches to increase vaccine uptake.
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Skowronski DM, Janjua NZ, De Serres G, Sabaiduc S, Eshaghi A, Dickinson JA, Fonseca K, Winter AL, Gubbay JB, Krajden M, Petric M, Charest H, Bastien N, Kwindt TL, Mahmud SM, Van Caeseele P, Li Y. Low 2012-13 influenza vaccine effectiveness associated with mutation in the egg-adapted H3N2 vaccine strain not antigenic drift in circulating viruses. PLoS One 2014; 9:e92153. [PMID: 24667168 PMCID: PMC3965421 DOI: 10.1371/journal.pone.0092153] [Citation(s) in RCA: 317] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 02/17/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Influenza vaccine effectiveness (VE) is generally interpreted in the context of vaccine match/mismatch to circulating strains with evolutionary drift in the latter invoked to explain reduced protection. During the 2012-13 season, however, detailed genotypic and phenotypic characterization shows that low VE was instead related to mutations in the egg-adapted H3N2 vaccine strain rather than antigenic drift in circulating viruses. METHODS/FINDINGS Component-specific VE against medically-attended, PCR-confirmed influenza was estimated in Canada by test-negative case-control design. Influenza A viruses were characterized genotypically by amino acid (AA) sequencing of established haemagglutinin (HA) antigenic sites and phenotypically through haemagglutination inhibition (HI) assay. H3N2 viruses were characterized in relation to the WHO-recommended, cell-passaged vaccine prototype (A/Victoria/361/2011) as well as the egg-adapted strain as per actually used in vaccine production. Among the total of 1501 participants, influenza virus was detected in 652 (43%). Nearly two-thirds of viruses typed/subtyped were A(H3N2) (394/626; 63%); the remainder were A(H1N1)pdm09 (79/626; 13%), B/Yamagata (98/626; 16%) or B/Victoria (54/626; 9%). Suboptimal VE of 50% (95%CI: 33-63%) overall was driven by predominant H3N2 activity for which VE was 41% (95%CI: 17-59%). All H3N2 field isolates were HI-characterized as well-matched to the WHO-recommended A/Victoria/361/2011 prototype whereas all but one were antigenically distinct from the egg-adapted strain as per actually used in vaccine production. The egg-adapted strain was itself antigenically distinct from the WHO-recommended prototype, and bore three AA mutations at antigenic sites B [H156Q, G186V] and D [S219Y]. Conversely, circulating viruses were identical to the WHO-recommended prototype at these positions with other genetic variation that did not affect antigenicity. VE was 59% (95%CI:16-80%) against A(H1N1)pdm09, 67% (95%CI: 30-85%) against B/Yamagata (vaccine-lineage) and 75% (95%CI: 29-91%) against B/Victoria (non-vaccine-lineage) viruses. CONCLUSIONS These findings underscore the need to monitor vaccine viruses as well as circulating strains to explain vaccine performance. Evolutionary drift in circulating viruses cannot be regulated, but influential mutations introduced as part of egg-based vaccine production may be amenable to improvements.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Canada
- Case-Control Studies
- Child
- Child, Preschool
- DNA, Viral/genetics
- Female
- Hemagglutinin Glycoproteins, Influenza Virus/genetics
- Hemagglutinin Glycoproteins, Influenza Virus/immunology
- Humans
- Immunization
- Infant
- Infant, Newborn
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/immunology
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza Vaccines/administration & dosage
- Influenza Vaccines/immunology
- Influenza, Human/genetics
- Influenza, Human/immunology
- Influenza, Human/prevention & control
- Influenza, Human/virology
- Male
- Middle Aged
- Molecular Sequence Data
- Mutation/genetics
- Protein Conformation
- Seasons
- Young Adult
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Affiliation(s)
- Danuta M. Skowronski
- Communicable Disease Prevention and Control Service, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Naveed Z. Janjua
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Gaston De Serres
- Department of Biological and Occupational Risks, Institut National de Santé Publique du Québec, Québec (Québec), Canada
- Department of Social and Preventive Medicine, Laval University, Québec (Québec), Canada
| | - Suzana Sabaiduc
- Communicable Disease Prevention and Control Service, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Alireza Eshaghi
- Department of Molecular Research, Public Health Ontario, Toronto, Ontario, Canada
| | - James A. Dickinson
- Family Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Kevin Fonseca
- Department of Virology, Provincial Laboratory of Public Health, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Anne-Luise Winter
- Communicable Disease Prevention and Control, Public Health Ontario, Toronto, Ontario, Canada
| | - Jonathan B. Gubbay
- Department of Microbiology, Public Health Ontario, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology and Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mel Krajden
- Communicable Disease Prevention and Control Service, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Martin Petric
- Communicable Disease Prevention and Control Service, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Hugues Charest
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Québec, Canada
- Département De Microbiologie, Infectiologie et Immunologie, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Nathalie Bastien
- Influenza and Respiratory Virus Section, National Microbiology Laboratory, Winnipeg, Manitoba, Canada
| | - Trijntje L. Kwindt
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Salaheddin M. Mahmud
- Community Health Sciences and Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Paul Van Caeseele
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Yan Li
- Influenza and Respiratory Virus Section, National Microbiology Laboratory, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
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6
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McNeil SA, Shinde V, Andrew M, Hatchette TF, LeBlanc J, Ambrose A, Boivin G, Bowie WR, Diaz-Mitoma F, ElSherif M, Green K, Haguinet F, Halperin S, Ibarguchi B, Katz K, Langley JM, Lagacé-Wiens P, Light B, Loeb M, McElhaney JE, MacKinnon-Cameron D, McCarthy AE, Poirier M, Powis J, Richardson D, Semret M, Smith S, Smyth D, Stiver G, Trottier S, Valiquette L, Webster D, Ye L, McGeer A. Interim estimates of 2013/14 influenza clinical severity and vaccine effectiveness in the prevention of laboratory-confirmed influenza-related hospitalisation, Canada, February 2014. Euro Surveill 2014; 19. [DOI: 10.2807/1560-7917.es2014.19.9.20729] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- S A McNeil
- Canadian Center for Vaccinology, IWK Health Centre and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - V Shinde
- GlaxoSmithKline Biologicals, Wavre, Belgium
| | - M Andrew
- Canadian Center for Vaccinology, IWK Health Centre and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - T F Hatchette
- Canadian Center for Vaccinology, IWK Health Centre and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - J LeBlanc
- Canadian Center for Vaccinology, IWK Health Centre and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - A Ambrose
- Canadian Center for Vaccinology, IWK Health Centre and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - W R Bowie
- University of British Columbia, Vancouver, British Columbia, Canada
| | - F Diaz-Mitoma
- Advanced Medical Research Institute of Canada, Sudbury, Ontario, Canada
| | - M ElSherif
- Canadian Center for Vaccinology, IWK Health Centre and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - K Green
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | - F Haguinet
- GlaxoSmithKline Biologicals, Wavre, Belgium
| | - S Halperin
- Canadian Center for Vaccinology, IWK Health Centre and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - B Ibarguchi
- GlaxoSmithKline, Mississauga, Ontario, Canada
| | - K Katz
- North York General Hospital, Toronto, Ontario, Canada
| | - JM Langley
- Canadian Center for Vaccinology, IWK Health Centre and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - B Light
- St. Boniface Hospital, Winnipeg, Manitoba, Canada
| | - M Loeb
- McMaster University, Hamilton, Ontario, Canada
| | - J E McElhaney
- Advanced Medical Research Institute of Canada, Sudbury, Ontario, Canada
| | - D MacKinnon-Cameron
- Canadian Center for Vaccinology, IWK Health Centre and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - M Poirier
- Centre de santé et de service sociaux de Trois-Rivieres, Trois-Rivieres, Quebec, Canada
| | - J Powis
- Toronto East General Hospital, Toronto, Ontario, Canada
| | - D Richardson
- William Osler Health Centre, Brampton, Ontario, Canada
| | - M Semret
- McGill University, Montreal, Quebec, Canada
| | - S Smith
- University of Alberta, Edmonton, Alberta, Canada
| | - D Smyth
- The Moncton Hospital, Moncton, New Brunswick, Canada
| | - G Stiver
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - L Valiquette
- Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - D Webster
- Horizon Health, Saint John, New Brunswick, Canada
| | - L Ye
- Canadian Center for Vaccinology, IWK Health Centre and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - A McGeer
- Mount Sinai Hospital, Toronto, Ontario, Canada
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7
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Halperin BA, MacKinnon-Cameron D, McNeil S, Kalil J, Halperin SA. Maintaining the momentum: key factors influencing acceptance of influenza vaccination among pregnant women following the H1N1 pandemic. Hum Vaccin Immunother 2014; 10:3629-41. [PMID: 25668670 PMCID: PMC4514062 DOI: 10.4161/21645515.2014.980684] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 08/21/2014] [Accepted: 09/13/2014] [Indexed: 11/19/2022] Open
Abstract
This survey study compared pre- and post-pandemic knowledge, attitudes, beliefs, and intended behaviors of pregnant women regarding influenza vaccination (seasonal and/or pandemic) during pregnancy in order to determine key factors influencing their decision to adhere to influenza vaccine recommendations. Only 36% of 662 pre-pandemic respondents knew that influenza was more severe in pregnant women, compared to 62% of the 159 post-pandemic respondents. Of the pre-pandemic respondents, 41% agreed or strongly agreed that that it was safer to wait until after the first 3 months to receive the seasonal influenza vaccine, whereas 23% of the post-pandemic cohort agreed or strongly agreed; 32% of pre-pandemic participants compared to 11% of post-pandemic respondents felt it was best to avoid all vaccines while pregnant. Despite 61% of the pre-pandemic cohort stating that they would have the vaccine while pregnant if their doctor recommended it and 54% citing their doctor/nurse as their primary source of vaccine information, only 20% said their doctor discussed influenza vaccination during their pregnancy, compared to 77% of the post-pandemic respondents who reported having this conversation. Women whose doctors discussed influenza vaccine during pregnancy had higher overall knowledge scores (P<0.0001; P=0.005) and were more likely to believe the vaccine is safe in all stages of pregnancy (P<0.0001; P=0.001) than those whose doctors did not discuss influenza vaccination. The 2009 H1N1 pandemic experience appeared to change attitudes and behaviours of health care providers and their pregnant patients toward influenza vaccination.
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Affiliation(s)
- Beth A Halperin
- Canadian Center for Vaccinology; Dalhousie University and the IWK Health Centre; Halifax, NS Canada
- Department of Pediatrics; Dalhousie University and the IWK Health Center; Halifax, NS Canada
| | - Donna MacKinnon-Cameron
- Canadian Center for Vaccinology; Dalhousie University and the IWK Health Centre; Halifax, NS Canada
| | - Shelly McNeil
- Canadian Center for Vaccinology; Dalhousie University and the IWK Health Centre; Halifax, NS Canada
- Department of Medicine; Dalhousie University ; Halifax, NS Canada
| | - Jennifer Kalil
- Canadian Center for Vaccinology; Dalhousie University and the IWK Health Centre; Halifax, NS Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology; Dalhousie University and the IWK Health Centre; Halifax, NS Canada
- Department of Pediatrics; Dalhousie University and the IWK Health Center; Halifax, NS Canada
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