Interventions to increase uptake of influenza vaccination in pregnancy: A systematic review and meta-analysis

Int J Gynaecol Obstet. 2023 Jul;162(1):39-50. doi: 10.1002/ijgo.14714. Epub 2023 Feb 24.

Abstract

Background: Maternal influenza vaccination has been introduced in several countries to prevent influenza-related morbidity and mortality in pregnant women, fetuses, and infants too young to be vaccinated.

Objectives: To analyze the available randomized controlled trials (RCTs) on the effectiveness of pregnant women-focused interventions to increase influenza vaccination uptake during pregnancy.

Search strategy: Medline, CINAHL, Scopus, Web of Science, and Cochrane Trial were searched on August 25, 2021.

Selection criteria: RCTs assessing the effectiveness of pregnant women-focused interventions in increasing influenza vaccination among pregnant women were included.

Data collection and analysis: Two independent reviewers extracted data. A random-effects meta-analysis was conducted to estimate pooled odds ratios (ORs).

Main results: Seven RCTs were selected. Overall, the interventions had a significant effect in increasing influenza vaccination during pregnancy compared with standard care (OR 1.78, 95% confidence interval [CI] 1.25-2.54; P = 0.001; I2 = 67%). However, subgroup analysis suggested that influenza vaccination uptake only was associated with educational interventions (OR 2.71, 95% CI 1.93-3.81; P < 0.001; I2 = 0%).

Conclusions: We found that several educational interventions for pregnant women can effectively increase influenza vaccination uptake in this population. Specifically, pamphlets, websites, and brief one-to-one education can be effective tools.

Registration: CRD42021269478.

Keywords: flu; immunization; influenza vaccine; interventions; maternal vaccination; pregnancy; strategies; vaccine hesitancy.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Family
  • Female
  • Humans
  • Infant
  • Influenza Vaccines*
  • Influenza, Human* / prevention & control
  • Odds Ratio
  • Pregnancy
  • Pregnant Women
  • Vaccination

Substances

  • Influenza Vaccines