Uptake of flu vaccination in pregnancy varies with age, ethnicity and socio-economic deprivation

Pregnant women are at an increased risk from influenza (flu), yet uptake of  Seasonal influenza vaccination (SIV) during pregnancy remains low, despite increases since 2010.

Getting the flu vaccine when pregnant is important, because it reduces the risk of severe disease, complications and adverse outcomes for both mother and child such as pre-term birth. However, uptake was lower among women living in more deprived areas, women who were younger or older than average, Black women and those with undocumented ethnicity. 

Although the flu vaccine is safe and recommended for pregnant women, misconceptions about safety play a role in pregnant women not being vaccinated. 

Flu vaccination levels among pregnant women are suboptimal worldwide. 

In the UK, since 2010, the Joint Committee on Vaccination and Immunisation has recommended that pregnant women get the flu vaccine to provide protection during the winter flu season. Despite these recommendations, data from Public Health England show that in 2020-21, fewer than half of pregnant women were vaccinated.

Previous studies of influenza vaccine uptake during pregnancy have either used data from a single care provider, or from surveys. Our retrospective cohort study looked at 450,000 pregnancies among 260,000 women in North West London, over a ten year period. By applying statistical models to data on women’s age, ethnicity, health conditions and socio-economic deprivation, we were able to identify groups with lower uptake of the flu vaccine. 

Misconceptions about the safety and efficacy of antenatal vaccinations play a role in pregnant women being unvaccinated, while recommendation by health professionals improves uptake. To ensure access to vaccines, for high uptake among pregnant women, strong primary care systems are needed and targeted approaches are recommended to reducing inequalities in access to vaccination and should focus on women of Black ethnicity, younger and older women, and women living in deprived areas. 

Our Characteristics associated with influenza vaccination uptake in pregnancy: a retrospective cohort study was published today, Tuesday 24th January 2023, read a copy via the British Journal of General Practice, Online First 2023.

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Title: Health and socio-demographic characteristics associated with uptake of seasonal influenza vaccination amongst pregnant women: Retrospective cohort study

Authors: Thomas Woodcock, Vesselin Novov, Helen Skirrow, James Butler, Derryn Lovett, Yewande Adeleke, Mitch Blair, Sonia Saxena, Azeem Majeed and Paul Aylin