Use of an Evidence-Based Approach to Improve Influenza Vaccination Uptake in Pregnancy

Influenza can be a significant health threat for any affected individual. Pregnant women are a high-risk population because of the likelihood of developing severe disease. Although the influenza vaccine has been recommended for use by pregnant women since 2004, current vaccination rates among pregnant women are lower than the general population and other high-risk groups.

A quality improvement project was undertaken during the 2019-to-2020 influenza season to increase the uptake of the influenza vaccine by women who were pregnant. The primary objective of the project was to increase the influenza vaccination rate compared with the rate in the previous season. The project had a secondary objective of standardizing documentation of the patient's vaccination status in the health record to capture data for performance measures. Interventions directed at patients, health care providers, and the health care system were simultaneously implemented as recommended by the Community Preventive Services Task Force.

Data were collected from 2967 records with 1480 from the 2018-to-2019 season and 1487 from the 2019-to-2020 season. Compared with records from the 2018-to-2019 season, the rate of those associated with a documented influenza vaccine was higher in the 2019-to-2020 season (63% vs 59%; P = .01). The rate of records without vaccination status codes was significantly less in the 2019-to-2020 season compared with the 2018-to-2019 season (14% vs 23%; P < .001).

Although interventions were effective in improving influenza vaccination uptake among pregnant women, vaccination rates still remain below the 80% goal set by the US Department of Health and Human Services. Bundled interventions have proven to be more effective than individual interventions, although which interventions are most effective remains unclear.