Gebelerin Mevsimsel İnfluenza Aşısı ile İlgili Bilgi, Tutum ve Davranışları

Yıl 2020, Cilt: 25 Sayı: 3, 258 - 263, 29.10.2020

Gülnur Kul Nail Erdoğan

https://doi.org/10.21673/anadoluklin.747921

Cited By: 2

Öz

Amaç: Gebelikte influenza enfeksiyonu, daha yüksek morbidite/mortalite ve de maternal, fetal ve neonatal risklerde artışla seyretmektedir. İnfluenzayı önlemede en etkili strateji aşılamadır. Bu çalışmada bir grup gebenin mevsimsel influenza aşısı ile ilgili bilgi, tutum ve davranışlarını değerlendirmek amaçlanmıştır.

Gereç ve Yöntemler: Çalışmamız bir kesitsel anket çalışması olarak, Ocak 2019—Temmuz 2019 döneminde kadın hastalıkları ve doğum polikliniğimize başvuran birinci, ikinci ve üçüncü trimesterdeki erişkin gebelerle gerçekleştirildi. Araştırmacılar tarafından ilgili literatür incelenerek, 17 sorudan oluşan bir anket hazırlandı ve ardından yüz yüze görüşme yoluyla uygulandı. Anketteki sorularla katılımcıların obstetrik, demografik ve sosyoekonomik özellikleri, gebelikte influenza aşısı olma öyküsü ve de gebelikte influenza aşısı ile ilgili bilgi, tutum ve davranışları sorgulandı.

Bulgular: Çalışma toplam 227 gebe içerdi. İnfluenza aşısının gebelikte güvenli olduğunu düşünenler çoğunlukla üniversite mezunu katılımcılardı. Yalnızca 19 (%8,3) katılımcı gebeyken influenza aşısı yaptırdığını belirtti. Katılımcıların aşılanmama gerekçeleri sorgulandığında, başlıca (%71,7) gerekçe “aşının bebeğe yan etki oluşturması endişesi” iken bunu “aşının gereksiz ve gebelerde yeterince denenmemiş olması” (%8,3) izledi. Gebelikte influenza aşısı yaptıran katılımcılar aşı yaptırmaları gerektiğini çoğunlukla (%80) aile hekiminden öğrenmişti.

Tartışma ve Sonuç: Çalışmamızda katılımcılarımızın genel olarak influenza aşısı hakkında yeterince bilgi sahibi olmadığı ve sağlık çalışanlarının, özellikle de hekimlerin aşıyı yeterince önermediği görülmüştür. Aile hekimleri ile kadın hastalıkları ve doğum uzmanlarının rutin takiplerde influenza aşısını önermeleri, yüksek risk gruplarından olan gebe kadınların bilgilendirilmesinde büyük önem taşımaktadır.

Anahtar Kelimeler

Aşılama, Gebelik, İnfluenza

Seasonal Influenza Vaccination-related Knowledge, Attitudes, and Behaviors of Pregnant Women

Öz

Aim: In pregnancy, influenza infection is associated with higher morbidity/mortality and an increase in maternal, fetal, and neonatal risks. Vaccination is the most effective strategy in the prevention of influenza. In this study, we aimed to evaluate the seasonal influenza vaccination-related knowledge, attitudes, and behaviors of a group of pregnant women.

Materials and Methods: The study was a cross-sectional survey study and included adult pregnant women in the first, second, and third trimesters who visited our outpatient obstetric clinic between January and July 2019. Based on the literature review performed, a 17-item questionnaire was prepared by the researchers, which was then administered by face-to-face interview. The questionnaire inquired about the participants’ obstetric, demographic and socioeconomic characteristics, history of influenza vaccination during pregnancy, and knowledge, attitudes and behaviors in the context of influenza vaccination during pregnancy.

Results: The study included a total of 227 pregnant women. Those who thought that influenza vaccines were safe during pregnancy were mostly university graduates. Only 19 (8.3%) reported having an influenza vaccination while they were pregnant. When the participants’ reasons for not being vaccinated were inquired, the main (71%) reason was “concern about the vaccine’s adverse effects on babies”, followed by “the vaccine being unnecessary and not adequately tested in pregnant women” (8.3%). Most (80%) of the participants who had an influenza vaccination during pregnancy received the information that they should be vaccinated from their family doctors.

Discussion and Conclusion: We found that our participants’ knowledge about the influenza vaccine was generally insufficient, and that influenza vaccination was not adequately promoted by health-care workers, particularly physicians. Recommendations by family doctors, gynecologists, and obstetricians for influenza vaccination during routine follow-up visits play a central role in the information of pregnant women as a high-risk group.

Anahtar Kelimeler

Vaccination, Influenza, Pregnancy

Kaynakça

• 1. Rasmussen SA, Jamieson DJ, Uyeki TM. Effects of influenza on pregnant women and infants. Am J Obstet Gynecol. 2012;207(3):S3–S8.
• 2. Healy CM, Baker CJ. Prospects for prevention of childhood infections by maternal immunization. Curr Opin Infect Dis. 2006;19(3):271–6.
• 3. Fell DB, Sprague AE, Liu N, Yasseen AS III, Wen SW, Smith G, ve ark. H1N1 influenza vaccination during pregnancy and fetal and neonatal outcomes. Am J Public Health Nations Health. 2012;102(6):e33–e40.
• 4. Richards JL, Hansen C, Bredfeldt C, Bednarczyk RA, Steinhoff MC, Adjaye-Gbewonyo D, ve ark. Neonatal outcomes after antenatal influenza immunization during the 2009 H1N1 influenza pandemic: impact on preterm birth, birth weight, and small for gestational age birth. Clin Infect Dis. 2013;56(9):1216–22.
• 5. Rasmussen SA, Jamieson DJ, Bresee JS. Pandemic influenza and pregnant women. Emerg Infect Dis. 2008;14(1):95.
• 6. Neuzil KM, Reed GW, Mitchel EF, Simonsen L, Griffin MR. Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women. Am J Epidemiol. 1998;148(11):1094–102.
• 7. Cox S, Posner SF, McPheeters M, Jamieson DJ, Kourtis AP, Meikle S. Hospitalizations with respiratory illness among pregnant women during influenza season. Obstet Gynecol. 2006;107(6):1315–22.
• 8. Dodds L, McNeil SA, Fell DB, Allen VM, Coombs A, Scott J, ve ark. Impact of influenza exposure on rates of hospital admissions and physician visits because of respiratory illness among pregnant women. CMAJ. 2007;176(4):463–8.
• 9. Fell DB, Azziz-Baumgartner E, Baker MG, Batra M, Beauté J, Beutels P, ve ark. Influenza epidemiology and immunization during pregnancy: final report of a World Health Organization working group. Vaccine. 2017;35(43):5738–50.
• 10. Dünya Sağlık Örgütü. Vaccines against influenza, WHO position paper—November 2012. Erişim: www.who.int/wer/2012/wer8747/en (erişildi: 20.5.2020) 11. T.C. Resmi Gazete (26.11.2016-29900). Sosyal Güvenlik Kurumu Sağlık Uygulama Tebliğinde Değişiklik Yapılmasına Dair Tebliğ.
• 12. Fell D, Platt R, Lanes A, Wilson K, Kaufman J, Basso O, ve ark. Fetal death and preterm birth associated with maternal influenza vaccination: systematic review. BJOG. 2015;122(1):17–26.
• 13. Mereckiene J. Seasonal influenza vaccination in Europe—Overview of vaccination recommendations and coverage rates in the EU Member States for the 2012–13 influenza season. Stockholm: European Centre for Disease Prevention and Control; 2015:11.
• 14. Freund R, Le Ray C, Charlier C, Avenell C, Truster V, Tréluyer JM, ve ark. Determinants of non-vaccination against pandemic 2009 H1N1 influenza in pregnant women: a prospective cohort study. PLoS One. 2011;6(6):e20900.
• 15. Fabry P, Gagneur A, Pasquier JC. Determinants of A (H1N1) vaccination: cross-sectional study in a population of pregnant women in Quebec. Vaccine. 2011;29(9):1824–9.
• 16. The American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 753: Assessment and treatment of pregnant women with suspected or confirmed influenza. Obstet Gynecol. 2018;132(4):e169–e173.
• 17. Yudin MH, Salaripour M, Sgro MD. Pregnant women’s knowledge of influenza and the use and safety of the influenza vaccine during pregnancy. J Obstet Gynaecol Can. 2009;31(2):120–5.
• 18. D’Alessandro A, Napolitano F, D’Ambrosio A, Angelillo IF. Vaccination knowledge and acceptability among pregnant women in Italy. Hum Vaccin Immunother. 2018;14(7):1573–9.
• 19. Mendoza-Sassi RA, Linhares AO, Schroeder FMM, Maas NM, Nomiyama S, César JA. Vaccination against influenza among pregnant women in southern Brazil and associated factors. Cien Saude Colet. 2019;24:4655–64.
• 20. Akın L. Türkiye’de pandemik grip epidemiyolojisi. Hacettepe Tıp Derg. 2010;41(1):5–12.
• 21. Dünya Sağlık Örgütü. Pandemic (H1N1) 2009–Update 112. Cenevre: Dünya Sağlık Örgütü; 2010.
• 22. Dünya Sağlık Örgütü. Situation update in the European Region: overview of influenza surveillance data week 40/2009 to week 07/2010. Erişim: www.euro.who.int/__data/assets/pdf_file/0003/91839/E93581.pdf (erişildi: 27.07.2020).
• 23. Dede F, Celen S, Bilgin S, Ure G, Ozcan A, Buzgan T, ve ark. Maternal deaths associated with H1N1 influenza virus infection in Turkey: a whole‐of‐population report. BJOG. 2011;118(10):1216–22.
• 24. ABD Hastalık Kontrol ve Önleme Merkezleri. 2009 pandemic influenza A (H1N1) in pregnant women requiring intensive care—New York City, 2009. MMWR Morb Mortal Wkly Rep. 2010;59(11):321–6.
• 25. Munoz FM, Greisinger AJ, Wehmanen OA, Mouzoon ME, Hoyle JC, Smith FA, ve ark. Safety of influenza vaccination during pregnancy. Am J Obstet Gynecol. 2005;192(4):1098–106.
• 26. Blanchard-Rohner G, Siegrist CA. Vaccination during pregnancy to protect infants against influenza: why and why not? Vaccine. 2011;29(43):7542–50.
• 27. Celikel A, Ustunsoz A, Guvenc G. Determination of vaccination status of pregnant women during pregnancy and the affecting factors. J Clin Nurs. 2014;23(15–16):2142–50.
• 28. Yakut N, Soysal S, Soysal A, Bakir M. Knowledge and acceptance of influenza and pertussis vaccinations among pregnant women of low socioeconomic status in Turkey. Hum Vaccin Immunother. 2020;16(5):1101–8.
• 29. Descamps A, Launay O, Bonnet C, Blondel B. Seasonal influenza vaccine uptake and vaccine refusal among pregnant women in France: results from a national survey. Hum Vaccin Immunother. 2020;16(5):1093–100.
• 30. Strassberg ER, Power M, Schulkin J, Stark LM, Mackeen AD, Murtough KL, ve ark. Patient attitudes toward influenza and tetanus, diphtheria and acellular pertussis vaccination in pregnancy. Vaccine. 2018;36(30):4548–54.