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\nInfluenza (the flu) can cause a woman to become very sick if she is pregnant (1).
\nInfants younger than 6 months old are also at high risk of severe illness from the flu, but they are too young to be vaccinated themselves (3).
\nThe national Healthy People 2020 target for flu vaccination among pregnant women is 80% (6). By season, coverage has varied:
\nCDC analyzed data from an internet panel survey conducted November 1-9, 2012 of women who were pregnant any time since July 2012 to provide a timely estimate of vaccination coverage among pregnant women. The results of this survey provide information for use by vaccination campaigns during National Influenza Vaccination Week (December 2-8, 2012). This report provides early-flu season (early November) estimates of vaccine uptake by pregnant women so far this year. Final 2012-13 flu season coverage estimates for pregnant women will become available after the end of the season.
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\nOverall early season estimates of flu vaccination coverage among pregnant women were similar in 2012-13 (47.3%) compared to the prior season (43.2%). Flu vaccination coverage among women who reported their doctor or other medical professional both recommended and offered the flu vaccine was 73.5%, approaching the Healthy People 2020 target of 80% (6). Yet the coverage estimates among women who reported receiving only a recommendation or not receiving a recommendation were much lower. Among women who were pregnant at the time of the survey, a safety concern was the most common reason for not receiving a flu vaccination among women who were pregnant at the time of the survey (43.4%). Continued efforts are needed to improve flu vaccination coverage among pregnant women, including:
\nThe November internet panel survey of pregnant women is designed to provide timely estimates of national flu vaccination coverage and to assess the effectiveness of current vaccination efforts. The follow-up survey in April 2013 will provide end of season flu vaccination coverage estimates.
\n \nCDC conducted an internet panel survey during November 1-9, 2012, to provide early season estimates of flu vaccination coverage and information on knowledge, attitudes, and behaviors related to flu vaccination among pregnant women. Women 18\u201349 years who were pregnant at any time since July 1, 2012, were recruited from a SurveySpot, a general population Internet panel, the same recruitment mechanism that was used in the November 2011 survey. Eligible respondents were either pregnant or recently pregnant at the time of the survey. Of all panel members, 2,194 who were eligible and started the survey, 2,073 (94.5%) completed the online survey. The sample was weighted to reflect the age group, racial/ethnic, and geographic distribution of the total U.S. population of pregnant women during 1995 \u2013 2008 (13\u201314).
\nSurvey respondents were asked if they had a flu vaccination since July 1, 2012, and if yes, in which month and whether it was before, during, or after pregnancy. Pregnancy status questions included whether respondents were currently pregnant or pregnant at any time since July 1, 2012, and if so, what were the actual months of pregnancy. Respondents were asked their beginning and end (or expected delivery) date of the pregnancy. All respondents were asked if their doctor or other medical professional had recommended flu vaccine, had offered them flu vaccination during an office visit, and their attitudes towards and beliefs about flu and flu vaccination.
\nWeighted analyses were conducted using SAS v9.2 survey procedure. Because the opt-in Internet panel sample is based on those who initially self-selected for participation in the panel rather than a random probability sample, statistical measures such as calculation of confidence intervals and tests of differences cannot be performed.
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\nThese results are preliminary and should be interpreted with caution. The follow-up internet panel survey in April 2013 will allow for assessment of flu vaccination coverage at the end of the flu season. State-specific estimates of flu vaccination coverage for the 2012-13 season will be provided later from the Pregnancy Risk Assessment Monitoring System (PRAMS). National coverage estimates from the Behavioral Risk Factor Surveillance System (BRFSS) will be provided later for comparison to the internet panel survey estimates.
\nThe findings in the report are subject to several limitations.
\nDespite these limitations, internet panel surveys are a useful surveillance tool for timely early season and postseason evaluation of flu vaccination coverage and knowledge, attitude, practice, and barrier data.
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\nAUTHORS: Helen Ding, MD, MSPH, Gary L Euler, Dr.PH, Erin D. Kennedy, DVM, MPH, Stacie M, Greby, DVM, MPH; Immunization Services Division, NCIRD
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\n* Vaccinated as of early-November based on women that provided a response to vaccination status questions and were pregnant anytime during August-November for the 2010-11 (n=1486) and 2011-12 (n=2,047) influenza seasons and July- November for the 2012-13 influenza season (n=2072).
\n\u2020 Vaccinated as of mid-April based on women that provided a response to vaccination status questions and were pregnant anytime during October 2010-January 2011 for the 2010-11 influenza season (n=1,457) and women that were pregnant anytime during October 2011-January 2012 for the 2011-12 influenza season (n=1,660).
\n\u2021 Currently have conditions associated with increased risk for serious medical complications from influenza, including chronic asthma, a lung condition other than asthma, a heart condition, diabetes, a kidney condition, a liver condition, or a weakened immune system caused by a chronic illness or by medicines taken for a chronic illness and obesity.
\n\u00a7 Safety concern is defined as the following responses: \u201cConcern about safety risk to the unborn baby\u201d, \u201cConcern vaccination would give me the flu\u201d, \u201cConcern about safety risk to myself\u201d, \u201cI don\u2019t trust the vaccine because it is too new and not enough research has been done\u201d, and \u201cConcern about side effects of the vaccination\u201d.
\n|| Efficacy of vaccine/severity of the flu is defined as the following responses: \u201cDon\u2019t think the vaccine is effective in preventing flu\u201d, \u201cI do not need the vaccination\u201d, and \u201cI don\u2019t get very sick or can treat it\u201d.
\n** Health reason is defined as the following responses: \u201cI get sick when I get the vaccination\u201d and \u201cI am allergic, on medication or the vaccination is not recommended to me\u201d.
\n\u2020\u2020 Psychosocial reason is defined as the following responses: \u201cAgainst religious/spiritual belief\u201d and \u201cI am afraid of needles/shots\u201d.
\n\u2021\u2021 Tangible barrier is defined as the following responses: \u201cNot covered by insurance/don\u2019t have insurance\u201d, \u201cThe flu vaccine costs too much\u201d, \u201cCopay cost too much\u201d, \u201c Don\u2019t have time/don\u2019t know where to go/who to call\u201d, and \u201cThe vaccination was not available\u201d.
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