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Predicting influenza vaccination coverage by pregnancy intent in women of childbearing age.

Smith, Sophie Elizabeth (2014)
Master's Thesis (129 pages)
Committee Chair / Thesis Adviser: Sullivan, Kevin M
Committee Members: Brammer, Lynnette (CDC);
Research Fields: Health Sciences, Epidemiology
Partnering Agencies: CDC
Keywords: Pregnancy intent; inluenza vaccination; influenza vaccine; Pregnancy
Program: Rollins School of Public Health, Epidemiology (Epidemiology)
Permanent url:


Influenza illness can result in severe complications, particularly in the high risk population of pregnant women. Maintaining high vaccination rates in women of childbearing age is one way to prevent severe outcomes as a result of influenza infection. The purpose of this investigation is to assess whether there is an association between pregnancy intent in women of childbearing age and receipt of the influenza vaccine. Data were taken from the Behavioral Risk Factor Surveillance System (BRFSS) from 2011 and included all women of childbearing age that answered the optional Preconception Health and Family Planning module of the questionnaire. The exposure was pregnancy intent, indicated by women that were considering pregnancy within 2 years, after 2 years, or not at all, and the outcome was the receipt of the influenza vaccine. Using multivariate logistic regression there was no overall significant association between considering pregnancy after 2 years (aOR: 0.94; 95%CI: 0.74, 1.20), or considering pregnancy within 2 years (aOR: 0.95; 95% CI: 0.71, 1.27) and vaccination status. Stratification by race showed a significant interaction among women of Asian, Native Hawaiian and other Pacific Islanders, American Indian, Alaskan Natives, Multiracial, and other non-specified races for both those considering pregnancy after 2 years, and women considering pregnancy within 2 years compared to not at all, with adjusted odds ratios of 0.14 (95% CI: 0.05, 0.40) and 0.39 (95%CI: 0.15, 0.99), respectively. Overall there was no significant association between pregnancy intent and vaccination status, but upon stratifying by race, there was significance among specific populations, and women of those populations considering pregnancy within 2 years or after 2 years were less likely to receive the influenza vaccine. This indicates that pregnancy intent in those populations is a significant predictor of influenza vaccination for this study population.

Table of Contents


Chapter I: Background and Literature Review


Chapter II: Manuscript













Table 1


Table 2


Table 3


Table 4


Chapter III: Summary, Implications, and Future Direction





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