Influenza Vaccination Among Pregnant Women in the United States: Findings from the 2012-2016 National Health Interview Survey

Background: The issue of suboptimal influenza vaccination coverage among pregnant women remains relevant. Our study aimed to explore the determinants and coverage of influenza vaccination among pregnant women in the United States using a nationally representative sample. Materials and Methods: This study was conducted with the 2012-2016 U.S. National Health Interview Survey. The Andersen's Health Behavior Model was applied as the conceptual framework to explore potential factors that may influence the influenza vaccination rate. A series of individual determinants, categorized into predisposing, enabling, and need factors, were compared using logistic regressions between women who received an influenza vaccination before or during pregnancy and those who did not. Results: An average of 36% women received an influenza vaccination before or during pregnancy among an estimated five million pregnant women. Even though the percentage increased from 31% in 2012 to 40% in 2016, it remained lower than the Healthy People 2020 target of 80%. The odds of receiving an influenza vaccination before or during pregnancy were lower among women who had public or no insurance coverage (odds ratio [OR]; 95% confidence interval, 0.510 [0.323-0.806] and 0.351 [0.175-0.705], respectively), lived in South (0.546 [0.336-0.887]), ever smoked 100 cigarettes (0.622 [0.419-0.923]), and had infrequent to light alcohol consumption in the past year (0.670 [0.457-0.983], reference: no alcohol consumption in the past year). Having a bachelor's degree increased the odds of getting an influenza vaccine compared to a high school diploma or less (2.086 [1.353-3.215]). Conclusions: Our study found that the influenza vaccination coverage among pregnant women remains suboptimal, and disparities may still exist across women with different sociodemographic and socioeconomic status. Clinicians should actively recommend influenza vaccination for pregnant women, and policy makers may consider developing interventions to improve the vaccination rate.