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PLoS One. 2019 Aug 1;14(8):e0220705. doi: 10.1371/journal.pone.0220705. eCollection 2019.

Does the availability of influenza vaccine at prenatal care visits and of immediate vaccination improve vaccination coverage of pregnant women?

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Maternité Port-Royal, Université Paris Descartes, Groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France.
DHU Risques et Grossesse, PRES Sorbonne Paris Cité, Paris, France.
Maternité Louis-Mourier, Université Diderot Paris 7, Hôpitaux Universitaires Paris Nord Val-de-Seine, Assistance Publique Hôpitaux de Paris, Colombes, France.
Maternité Bichat-Claude Bernard, Université Diderot Paris 7, Hôpitaux Universitaires Paris Nord Val-de-Seine, Assistance Publique Hôpitaux de Paris, Paris, France.
Université Paris Descartes, Sorbonne Paris Cité, Inserm, CIC 1417, AP-HP, Groupe Hospitalier Cochin-Broca-Hôtel-Dieu, Centre d'investigation Clinique Cochin-Pasteur,Paris, France.
Unité INSERM U953, Recherche épidémiologique en santé périnatale et santé des femmes et des enfants, UPMC, Paris, France.



Although vaccination against influenza is recommended for pregnant women in France because it exposes them to a risk of death and severe respiratory complications, their vaccination coverage in 2016 was estimated at 7%. This study's principal objective was to assess the association between the availability of influenza vaccination at prenatal care visits and vaccination coverage.


This multicenter survey took place in 3 Paris-area public hospital (AP-HP) maternity wards (A, B, and C). Only maternity ward A offered the vaccine and vaccination without charge at prenatal visits. Data were collected from parturients during 10 days in January 2017 by a self-administered anonymous questionnaire.


Data from 248 women showed overall vaccination coverage of 19.4% (48/248): 35.4% (46/130) in maternity unit A, 2.7% (2/75) in B, and 0% (0/43) in C (P<0.01). After adjustment for socio-demographic characteristics, women at maternity ward A were significantly more likely to be vaccinated than those at B and C (aOR 25.52, 95%CI [5.76-113.10]). Other factors significantly associated with higher vaccination coverage were the mother's French birth (aOR 2.37 CI [1.03-5.46]) and previous influenza vaccination (aOR 3.13, 95%CI [1.25-7.86]). Vaccinated women generally considered they had received adequate information (aOR 4.15 CI [2.10-8.22]), principally from the professional providing their prenatal care. Nonvaccination was attributed to the absence of an offer of vaccination (81.5%), fear of fetal side effects (59.5%), and inadequate information (51.4%).


Our results show that availability of influenza vaccination, free of charge, at prenatal consultations at the maternity ward increases vaccination coverage significantly.

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