Background

In 2017, three media stories regarding influenza vaccine may have impacted obstetricians’ (OB) influenza vaccination practices: reports of reduced influenza vaccine effectiveness, a severe influenza season, and a possible increased risk of miscarriage among pregnant women receiving 2009 H1N1 vaccine in the 1st trimester who had received H1N1 vaccine the previous season (later disproven).

Objective

Describe OB’s: (1) awareness of; (2) attitudes and experiences related to; and (3) reported alterations in practice as a result of these reports.

Methods

A survey among a nationally representative sample of OBs April to June 2018.

Results

Response rate was 65% (302/468). 88% of OBs were “very aware” of the severe season, 74% of lower effectiveness, and 25% of the miscarriage study (47% “completely unaware” of miscarriage study). Among those aware, 58%, 57%, and 16% reported ≥10% of pregnant patients initiated discussions about the severe season, lower effectiveness, and miscarriage study, respectively. Most (83%) agreed reports about increased severity increased their enthusiasm for recommending influenza vaccine; fewer agreed reports about the miscarriage study (18%) and lower vaccine effectiveness (12%) decreased their enthusiasm for recommending influenza vaccine. Providers were more likely to initiate discussion with patients about increased severity of the season than the other reports. However, 35% agreed the miscarriage study reports increased their concerns about influenza vaccine safety; 18% (n = 48) reported changing the way they recommended influenza vaccine. Of those, 17 (6% of all respondents) reported not recommending influenza vaccine to women during the 1st trimester and 26 (10% of all respondents) recommended it but were willing to delay until the 2nd trimester.

Conclusions

During a season in which media stories could have influenced OB influenza vaccination behaviors in different directions, reports underscoring importance of influenza vaccine may have had more impact on OBs’ recommendations than reports questioning vaccine safety or effectiveness.

中文翻译：

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媒体关于流感疫苗的报道对产科医生接种疫苗的影响

背景

2017 年，有关流感疫苗的三个媒体报道可能影响了产科医生 (OB) 的流感疫苗接种实践：有关流感疫苗有效性降低的报道、严重的流感季节以及在第 1 天接种 2009 H1N1 疫苗的孕妇流产风险可能增加上一季接种过 H1N1 疫苗的孕期孕妇（后来被证明无效）。

客观的

描述OB的：（1）意识；(2) 相关的态度和经验；(3) 由于这些报告而报告了实践中的变化。

方法

2018 年 4 月至 6 月对具有全国代表性的 OB 样本进行的调查。

结果

响应率为 65% (302/468)。88% 的 OB“非常了解”严重季节，74% 的效率较低，25% 的流产研究（47%“完全不知道”流产研究）。在知道的人中，分别有 58%、57% 和 16% 的人报告有 ≥10% 的孕妇发起了关于严重季节、有效性较低和流产研究的讨论。大多数 (83%) 同意关于严重程度增加的报告增加了他们推荐流感疫苗的热情；关于流产研究的较少同意报告 (18%) 和较低的疫苗有效性 (12%) 降低了他们推荐流感疫苗的热情。与其他报告相比，提供者更有可能与患者就季节的严重程度增加进行讨论。然而，35% 同意流产研究报告增加了他们对流感疫苗安全性的担忧；18% (n = 48) 报告说他们改变了推荐流感疫苗的方式。其中，17 人（占所有受访者的 6%）表示不建议在孕早期为女性接种流感疫苗，26 人（占所有受访者的 10%）建议接种流感疫苗但愿意推迟到孕中期。

结论

在媒体报道可能从不同方向影响 OB 流感疫苗接种行为的季节中，强调流感疫苗重要性的报道可能比质疑疫苗安全性或有效性的报道对 OB 的建议产生更大的影响。