HealthDay News — A recommendation to get the flu shot from a healthcare provider along with an offer to vaccinate improves influenza vaccine uptake among pregnant women, according to the CDC.

Vaccine coverage was 70.5% among women who received both a clinician recommendation and an offer to vaccinate, compared with just 46.3% among those who received a recommendation only and 16.1% among those who received neither, CDC researchers reported in Morbidity and Mortality Weekly Report.

“Education messages for pregnant women need to emphasize that vaccination during pregnancy can protect not only pregnant women themselves but also their infants during the first 6 months of life,” the agency wrote. “Such messages can be delivered through multiple means, including routine provider education, prenatal consultation, social media and text messaging.”

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The American College of Obstetricians and Gynecologists currently recommends all women who are pregnant or will be pregnant during the influenza season get the seasonal vaccine. 

To better understand influenza vaccination coverage in this population during the 2012-2013 influenza season, CDC researchers analyzed data from an Internet panel survey conducted April 1-12, 2013 that involved 1,702 self-selected survey respondents aged 18 to 49 years who were pregnant at any time from October 2012 to January 2013.

A total of 50.5% of respondents reported they received influenza vaccination before or during their pregnancy, 14.6% were vaccinated before pregnancy and 35.9% during pregnancy (15.7% first trimester, 10.6% second trimester, 8.1% third trimester and 1.5% unknown trimester).

Among the 1,620 women with at least one health-care provider visit since July 2012 who provided information on a provider recommendation and offer, 54.6% reported receiving a provider recommendation and an offer to vaccinate, 16.7% reported receiving a provider recommendation but no offer of vaccination, and 28.7% reported receiving no recommendation. 

Vaccination coverage among women with a negative attitude toward vaccine safety (13% vs. 65.6%) and efficacy (9.8% vs. 64.2%) was substantially lower than among those with a positive attitude.

Again a healthcare providers recommendation along with an offer to vaccine made a substantial difference in vaccine uptake in women with negative perceptions of vaccine safety (19.4% vs. 7.7%) and efficacy (19.4% vs. 2.5%) compared with no encouragement.

The top three reasons women reported for vaccination were to protect their infant from influenza (33.2%), to protect themselves from influenza (20.0%), and because their health-care provider recommended vaccination (15.7%).

The top three reasons reported for nonvaccination were concern about safety risk to the infant (20.5%), that the vaccination would give pregnant women influenza (13.6%), and that vaccination was not effective in preventing influenza (10.6%).

“Systems supporting provider recommendation and offer, such as standing orders and provider reminder systems, can reduce missed opportunities for vaccination and improve vaccination coverage when implemented with strategies to improve access to vaccination services, such as strategies that reduce patient cost and increase demand (e.g., patient education),” the CDC wrote.

The agency suggested implementing a combination of community-based interventions, including enhanced access to low-cost vaccination services, and education programs to teach pregnant women about influenza vaccine safety and efficacy during pregnancy.


  1. CDC. MMWR Morb Mortal Wkly Rep. 2013;62(38):787-92.