by Greg Attenweiler
For a woman of reproductive age that is pregnant, there is a heightened sense of awareness of “her body” and the “little stranger(s)” in her care. Bodily sensations remind her of the upcoming birth. People interject about what is best to do for the sake of the fetus. In the Orgcomplexity February 14, 2013 blog post, Michele Battle-Fisher evoked the idea of the dialectical confusion that can ensure over what is best for the mother, what is best for the fetus, and what is best for everyone “involved” in the pregnancy (http://wp.me/p32X8n-3d). But in terms of a potentially life-threatening condition such as contracting the flu during pregnancy, let’s take a moment to untangle the complex repercussions of vaccination on both mother and the fetus.
Though the general population is at risk for flu during a the moving target called the flu “season”, pregnant women are greater risk for complications. The best defense presently available to public health officials is the annual flu vaccine which is available to the general public each year before the typical flu season starts. The timing of pregnancy may not coincide with the CDC public service announcement deluge to get the vaccination. It may the last thing on the mind of both mother and the OB/GYN. According to the 2006 Pregnancy Risk Assessment and Monitoring System data, the second most cited reason for not receiving the influenza vaccination was the “physician did not mention anything about a flu vaccine during my pregnancy” (Shavell et al., 2012). Yet with such a potent defensive weapon against the flu, vaccinations rates have historically been poor among pregnant females with vaccination rates hovering below 15% (Kissin, et al, 2011). The seasonal flu vaccination rate among pregnant females reached an all-time high during the 2009 Swine flu epidemic of 32.7% which is still far below the Healthy People goal of 80% (Kissin et al., 2011).
As public health officials it is vital to determine what influenced pregnant females who received the annual flu vaccination to do so. This information can show public health officials the tipping point that needs to be focused on in order to influence pregnant women to receive the annual flu vaccine. Social network analysis can play key role in helping public health officials to determine this by studying the complex complete vaccination network which includes a motley crew of the Centers for Disease Control and Prevention, pharmaceutical companies, state health departments, county health departments, hospitals, OB/GYNs/physicians, nurses, friends, extended family members, spouses/partners and pregnant females themselves.
Studies conducted on pregnant females and their willingness to receive the influenza vaccination can provide insight as to what effect the stop of information flow could have on pregnant women, especially if the flow stops at their OB/GYN. A number of studies have shown that patient barriers such as belief, attitudes, perceptions, motivations, and expectations have a major impact on the vaccination of pregnant patients. Additional studies have shown that a powerful tool to overcome patient barriers to influenza vaccination is provider recommendation of vaccination, especially from an OB/GYN (Shavell, Moniz, Gonik, & Beigi, 2012). In a study carried out in 2009, 60% of the sample of postpartum women who received the influenza vaccination did so based on the recommendation of their OB/GYN (Shavell et al., 2012). Another 68% of pregnant woman stated they would consult their OB/GYNs before they would even consider getting the influenza vaccination. In addition, 89% of the pregnant women surveyed reported they would get the influenza vaccination if it was recommended by their OB/GYN, and 56% of postpartum women who did not receive the influenza vaccine would have accepted the vaccine if it were recommended by their OB/GYN (Shavell et al., 2012). OB/GYNs who recommend the influenza vaccination to their patients and address their concerns play a crucial role in ensuring compliance with vaccine recommendations.
Battle-Fisher, M. (2013, Jan. 14) Exploring the complexity of pregnancy disclosure within social networks. [Blog post]. Retrieved from http://wp.me/p32X8n-3d.
Kissin, D. et. al. (2011). Attitudes and Practices of Obstetrician-Gynecologists Regarding Influenza Vaccination in Pregnancy. Obstetrics and Gynecology, 118(5), 1074-1080. doi: 10.1097?AOG.0b013e3182329681
Shavell, V. I., Moniz, M. H., Gonik, B., & Beigi, R. H. (2012). Influenza immunization in pregnancy: Overcoming patient and health care provider barriers. American Journal of Obstetrics and Gynecology, 207(3 Suppl), S67-74. doi: 10.1016/j.ajog.2012.06.077