• Catherine L King, Maria Y Chow, Julie Leask, and Kerrie E Wiley.
• National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Locked Bag 4001, Westmead NSW 2145, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, The Children's Hospital at Westmead Clinical School, Locked Bag 4001,Westmead NSW 2145, Australia. Electronic address: catherine.king@health.nsw.gov.au.
• Women Birth. 2019 Jun 1; 32 (3): 240-245.

BackgroundPregnant women and their unborn children are at high risk from both pandemic and seasonal influenza.AimTo explore views about influenza vaccination during pregnancy, in a pandemic and immediate post-pandemic context, among mothers and other carers of young children.MethodsIn a mixed methods study, caregivers from 16 childcare centres in Sydney, Australia, were surveyed in November and December 2009, and interviews were conducted with caregivers from six childcare centres between June 2009 and May 2011.FindingsEmerging themes from 41 interviews conducted with mothers included: 'pregnancy as a protected state', 'risk negotiation' and 'centrality of healthcare worker interaction'. Of 972 surveys distributed, 431 were completed (a response rate of 44%). Respondents perceived pandemic influenza risks to be greater for pregnant women than for their unborn children. Only 2% (9/383) of women reported being vaccinated against swine flu during pregnancy and 45% (168/383) indicated intent to receive swine flu vaccination in a future pregnancy.DiscussionThe low rates of maternal influenza vaccination revealed in this study contrast to recent gains in vaccine uptake. Vaccination decision-making in pregnancy can be complex and contextually driven for some women. Healthcare workers, including midwives, have a key role in addressing women's concerns about maternal influenza vaccination in both pandemic and interpandemic periods.ConclusionsPolicy makers need to be cognisant of women's concerns and develop resources for both pregnant women and healthcare workers as part of both future pandemic planning and seasonal vaccination efforts.Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

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