Vaccination during pregnancy: Canadian maternity care providers' opinions and practices

Figures & data

Table 1. Study participants’ characteristics (n = 1,135)

	Providers who don’t vaccinate pregnant women in their practice (n = 503)^a		Providers who vaccinate pregnant women in their practice (n = 632)^a		Total (n = 1135)
Characteristics	N	%	N	%	N	%	P value
Profession
Family Physician/General practitioner	66	13.1	236	37.3	302	26.6	<.0001
Obstetrician-gynecologist	200	39.8	73	11.6	273	24.1
Midwife	190	37.8	28	4.4	218	19.2
Nurse	26	5.2	194	30.7	220	19.4
Pharmacist	18	3.6	95	15.0	113	10.0
Other	3	0.6	6	0.9	9	0.8
Gender
Male	57	11.3	54	8.6	111	9.8	.016
Female	433	86.1	568	90.6	1001	88.6
Other	13	2.6	5	0.8	18	1.6
Number of years of practice
Less than a year	50	10.0	35	5.6	85	7.5	<.0001
1–9 y	192	38.3	211	33.5	403	35.6
10–19 y	141	28.1	155	24.6	296	26.2
20–29 y	68	13.6	125	19.8	193	17.1
≥30 y	50	10.0	104	16.5	154	13.6
Professional training
Mostly received in Canada	447	89.4	592	94.6	1039	92.3	.0016
Mostly received outside Canada	53	10.6	34	5.4	87	7.7
N of pregnant patients seen each week
21 or more	291	58.4	171	27.5	462	41.3	<.0001
From 11 to 20	107	21.5	96	15.4	203	18.1
From 6 to 10	54	10.8	130	20.9	184	16.4
5 or less	46	9.2	225	36.2	271	24.2
Missing	5	-	10	-	15	-
Have received the flu vaccine during the 2016/17 season
Yes	373	74.2	578	91.5	951	83.8	<.0001
No	130	25.8	54	8.5	184	16.2
Have recommended the flu vaccine during the 2016/17 season
To all of my pregnant patients	264	52.5	495	78.7	759	67.0	<.0001
To some of my pregnant patients	158	31.4	97	15.4	255	22.5
To none of my pregnant patients	39	7.8	8	1.3	47	4.2
Don’t know/Prefer not to answer	42	8.3	29	4.6	71	6.3

^aMissing answers are excluded in the calculations of percentages.

Figure 1. Participants’ practices regarding vaccination

Table 2. Participants’ perceptions of vaccination counseling

	Providers who vaccinate pregnant patients in their practice^d n = 632		Providers who don’t vaccinate pregnant patients in their practice^d n = 503		Total^d n = 1,135
	n	% (Row)	n	% (Row)	n	% (Col)	P value
I am confident offering advice about vaccines to pregnant patients^a	496	78.5	299	59.4	795	70.2	<.0001
I am confident in vaccinating pregnant patients (myself or nurse/assistant working with me) as a part of my practice^b	557	88.1	211	41.9	768	69.2	<.0001
Delivering advice about vaccination to pregnant patients is easy for me^a	456	72.2	261	51.9	717	63.3	<.0001
I think other maternity care providers discuss vaccination with their pregnant patients^c	253	40.0	167	33.2	420	41.7	.06

^dOnly include “Strongly agree” and “Agree” responses.

^a2 missing responses; ^b−25 missing responses; ^c128 missing responses.

Figure 2. Participants’ perceptions of vaccination counseling by type of profession (% “Strongly agree” and “Agree responses”)

Table 3. Participants’ reported level of knowledge

	Providers who vaccinate pregnant patients in their practice^a n = 632		Providers who don’t vaccinate pregnant patients in their practice^a n = 503		Total^a n = 1,135
Reported level of knowledge on:	n	% (Row)	n	% (Row)	n	% (Col)	P value
Vaccination in general
None/Low	190	39.7	289	60.3	479	42.3	<.0001
High^a	441	67.4	213	32.6	654	57.7
Vaccination in pregnancy
None/Low^b	245	50.8	237	49.2	482	42.5	.005
High^a	386	59.3	265	40.7	651	57.5
Vaccination against influenza in pregnancy
None/Low^b	117	47.4	130	52.6	247	21.8	.004
High^a	513	58.0	372	42.0	885	78.2
Vaccination against pertussis in pregnancy
None/Low^b	256	47.0	289	53.0	545	48.2	<.0001
High^a	372	63.6	213	36.4	585	51.8

^bIncludes items 1 to 5 on an 8-point Likert scale ranging from Know nothing to Expert.

^aIncludes items 6 to 8 on an 8-point Likert scale ranging from Know nothing to Expert.

Figure 3. Participants’ trust in different sources of information about vaccination

Figure 4. Participants’ trust in different sources of information about vaccination by type of profession (%)

Figure 5. Participants’ opinions regarding pertussis vaccination in pregnancy (%)

Table 4. Factors associated with offering vaccination services to pregnant patients in practices offering vaccination services to other clientele (n = 724)^a

	Adjusted OR	95% CI		P value
Feeling confident in offering advice about vaccines to pregnant patients	6.2	3.4	11.4	<.0001
Seeing fewer than 11 pregnant patients on average each week (vs. seeing 11 or more pregnant patients each week)	2.8	1.5	5.1	.001
Being a nurse or a family physician (vs. being a midwife, an ob/gyn or a pharmacist)	2.2	1.2	4.0	.011
Having recommended influenza vaccine to all pregnant patients during last season	2.1	1.1	3.9	.021
Having received information on influenza vaccination for pregnant patients during last season	1.9	1.0	3.4	.041
Having a high reported level of knowledge on vaccination in general	1.8	1.0	3.4	.05

^aThe odds ratios were adjusted for all other variables shown in the model, as well as for province.