The purpose of this study was to compare influenza vaccination rates of pregnant women in a public safety-net health system to national coverage rates during the 2009-2010 pandemic influenza season. A chart review of a random sample of deliveries was undertaken to determine rates of coverage and predictors of vaccine coverage of women who obtained prenatal care and delivered in our health system. Rates were calculated from deliveries from when the vaccine was first available through April 30, 2010. Coverage rates were 54% for the seasonal influenza vaccine and 51% for the H1N1 vaccine. Race/ethnicity, insurance status and language spoken did not predict the receipt of either vaccine. When we included only births which occurred through March 12, 2010, as was done in a large population-based study, the rates were 61% and 59%, respectively. Our rates are about 10% higher than the rates reported in that study. Our comprehensive strategy for promoting vaccine coverage achieved higher vaccination rates in a safety-net health system, which serves groups historically less likely to be vaccinated, than those reported for the pregnant population at large. 1. Introduction Currently the influenza vaccine is recommended in the United States for all individuals over 6 months of age [1] and by the World Health Organization for high-risk groups [2]. These recommendations have, in part, the aim to reduce the worldwide estimated deaths 250,000–500,000 each year caused by the seasonal form of the disease [3]. Pregnant women are included in these recommendations because vaccination with the inactivated virus has been shown to decrease the burden of suffering among neonates [4–6] and to reduce maternal morbidity of the infection [7]. Furthermore, vaccination in pregnancy has been documented as sufficiently safe to be recommended to be given regardless of trimester [4, 8]. Despite these recommendations in pregnancy, coverage of pregnant women in the United States has been low in the years prior to the 2009-2010 influenza season (11% to 24%) [7]. Reasons cited for this include not being offered the vaccine, not having the vaccine in the office, and maternal concerns for vaccine safety [9, 10]. In the spring of 2009, a new swine-origin form of the influenza A virus, causing substantial morbidity and mortality, was isolated: H1N1 [11]. As part of the pandemic strategy for this virus, a specific monovalent vaccine for H1N1 was developed and was ready for distribution in the Fall of 2009 [12]. Among the high-risk groups targeted to receive this vaccine, in addition to the
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