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Attitudes, Experiences, and Behaviors of Pregnant Women and New Mothers During the H1N1 Pandemic Gillian SteelFisher, PhD, MSc Robert Blendon, ScD Harvard Opinion Research Program Harvard School of Public Health Funded as part of a cooperative agreement between

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Attitudes, Experiences, and Behaviorsof Pregnant Women and New MothersDuring the H1N1 Pandemic

Gillian SteelFisher, PhD, MSc

Robert Blendon, ScD

Harvard Opinion Research ProgramHarvard School of Public Health

Funded as part of a cooperative agreement between

HSPH, the National Public Health Information Coalition, and the CDC


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Emergency Polling

  • Technology transfer from politics

  • Support communications and material response in an emergency

  • Most common: telephone polls using randomized samples

  • Methodological issues: Lower response rates/weighted data

  • Advantages: Rapid results and less recall bias

  • Newer innovation: online polls of randomized samples

    • Reach low-incidence populations quickly


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Goals and Methods Summary

  • To examine attitudes, experiences and behaviors of pregnant women and “new mothers” (mothers of infants) during H1N1 pandemic

  • Conducted January 26-February 26, 2010

  • Representative online poll of pregnant women

    • Representative national sample of women aged 18 to 50 on Knowledge Network’s KnowledgePanelSM and then identified as pregnant/new mother

    • Email opt-in panel of pre-identified pregnant women and new mothers

  • 514 pregnant women; margin of error is +/- 6.1% at the 95% confidence level

  • 526 new mothers; margin of error is +/- 6.6% for new mothers at the 95% confidence level

  • Data weighted by: age, trimester (pregnant women) or age of baby (new mothers), race/ethnicity, geographic region, metropolitan status, income, education, and primary language proficiency among Hispanics

3


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Key Findings

  • While a sizable share of these groups said they got vaccinated, a majority did not; key barrier is perceived safety of the vaccine, especially for pregnant women and mothers vaccinating baby

  • For pregnant women: Key messages related to illness risk and vaccine benefits were associated with vaccination, but were not retained by large shares of the population

  • Recommendations from doctors, an especially trusted source, were associated with vaccination in both populations

  • Most women would follow appropriate recommendations for treatment if sick with H1N1

4

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.



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What share of pregnant women got the H1N1 vaccine?Why didn’t some get vaccinated?

6


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H1N1 Vaccination Among Pregnant Women

Since October 2009

% Among Pregnant Women

Got H1N1 vaccine for themselves

Intend to get H1N1 vaccine for themselves by the end of March 2010

Not sure if they will get the H1N1 vaccine for themselves by the end of March 2010

Do NOT intend to get H1N1 vaccine for themselves by the end of March 2010

7

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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H1N1 Vaccination Among Pregnant Women:

By Demographics

% Who Got the H1N1 Vaccine for Themselves

Under 35

By Age

*

35 and older

**

White, Non-Hispanic

By Ethnicity

Other

Some college or less

By Education

***

Graduated college or more

****

Working

By Employment Status

Not working

*Statistically significantly different from pregnant women who are under 35 at the 95% confidence level

**Statistically significantly different from pregnant women who are not white and/or are Hispanic at the 95% confidence level

***Statistically significantly different from pregnant women who have completed some college or less at the 95% confidence level

****Statistically significantly different from pregnant women who are not working at the 95% confidence level

8

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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Reasons Pregnant Women Will Not/Are Not Sure About Trying to Get H1N1 Vaccine for Themselves

% of pregnant women* saying “major reason”…

Concern about safety risks to baby

Concern about safety risks to self

Don’t think would get very sick if got H1N1

Don’t think at risk of getting H1N1

If get H1N1, can get medication to treat it

Health care provider recommended wait or not get it at all

Cannot afford to pay for the H1N1 flu vaccine

*Among pregnant women who said they will not or are not sure about trying to get the H1N1 vaccine for themselves by the end of March 2010 (n=216)

9

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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Where did pregnant women go for Get H1N1 Vaccine for Themselvesinformation about H1N1?What did they believe about the vaccine?What messages may have had an impact on vaccination decisions?

10


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Assessment of Risk from H1N1: Get H1N1 Vaccine for Themselves

Pregnant Women’s Knowledge as to Whether They Are More Likely to Get Seriously Ill than Others

% of pregnant women saying

Pregnant women are more likely to get seriously ill from H1N1

Pregnant women are NOT more likely to get seriously ill from H1N1

Don’t know whether pregnant women are more likely to get seriously ill from H1N1

11

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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H1N1 Vaccination Among Pregnant Women: Get H1N1 Vaccine for Themselves

By Belief about Pregnancy Risk

% Who Got the H1N1 Vaccine for Themselves

Among pregnant women who believe pregnant women are at greater risk of becoming seriously ill from H1N1 (n = 310)

*

Among pregnant women who do not know or do not believe that pregnant women are at greater risk of becoming seriously ill from H1N1 (n = 203)

*Statistically significantly different from pregnant women who do not know or do not believe this at the 95% confidence level

12

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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Knowledge Among Pregnant Women of Benefits Get H1N1 Vaccine for Themselves

of H1N1 Vaccination During Pregnancy

% of pregnant women saying

Getting H1N1 vaccine while pregnant provides baby with protection against H1N1

Getting H1N1 vaccine while pregnant does NOT provide baby with protection against H1N1

Not sure if getting H1N1 vaccine while pregnant provides baby with protection against H1N1

13

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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H1N1 Vaccination Among Pregnant Women: Get H1N1 Vaccine for Themselves

By Belief about Benefit to Fetus

% Who Got the H1N1 Vaccine for Themselves

Among pregnant women who believe that the H1N1 flu vaccine provides protection against H1N1 flu for their baby (n = 186)

*

Among pregnant women who do not know or do not believe that the H1N1 flu vaccine provides protection against H1N1 flu for their baby (n = 328)

*Statistically significantly different from pregnant women who do not know or do not believe this at the 95% confidence level

14

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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Pregnant Women’s Discussions About Getting the H1N1 Vaccine with Health Care Provider (HCP)

Pregnant Women who discussed getting the H1N1 vaccine while pregnant with HCP

HCP Recommendation*

*n=377

15

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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H1N1 Vaccination Among Pregnant Women: Vaccine with Health Care Provider (HCP)By Recommendation from Health Care Provider

% Who Got the H1N1 Vaccine for Themselves

Among pregnant women who received a recommendation from their HCP to get the H1N1 flu vaccine while pregnant (n = 326)

*

Among pregnant women who did not receive a recommendation from their HCP to get the H1N1 flu vaccine while pregnant (n = 187)

*Statistically significantly different from pregnant women who did not receive a recommendation from their HCP to get the H1N1 flu vaccine while pregnant at the 95% confidence level

16

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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NEW MOTHERS Vaccine with Health Care Provider (HCP)

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What share of new mothers got the H1N1 vaccine for themselves? For their babies?Why didn’t some get vaccinated?What role did their doctors play?

18


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H1N1 Vaccination Among New Mothers: themselves? For their babies?For Themselves and Their Babies*

% For Themselves

% For Their Baby

Got H1N1 vaccine

Intend to get H1N1 vaccine by the end of March 2010

Not sure if they will get the H1N1 vaccine by the end of March 2010

Do NOT intend to get H1N1 vaccine by the end of March 2010

*Among new mothers with infants 6 months or older (n=314)

19

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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Reasons New Mothers Will Not/Are Not Sure About Trying to Get H1N1 Vaccine for Themselves

% of new mothers* saying “major reason”…

Concern about safety risks

Don’t think at risk of getting H1N1

Don’t think would get very sick if got H1N1

If get H1N1, can get medication to treat it

Cannot afford to pay for the H1N1 flu vaccine

Health care provider recommended wait or not get it at all

*Among new mothers who said they will not or are not sure about trying to get the H1N1 vaccine for themselves by the end of March 2010 (n=270)

20

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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Reasons New Mothers Will Not/Are Not Sure About Trying to Get H1N1 Vaccine for their Infants

% of new mothers* saying “major reason”…

Concern about safety risks to baby

Don’t think baby is at risk of getting H1N1

Child’s doctor recommended wait or not get it at all

If baby gets H1N1, can get medication to treat it

Don’t think baby would get very sick if got H1N1

Cannot afford to pay for the H1N1 flu vaccine

*Among mothers of infants over 6 months old who said they will not or are not sure about trying to get the H1N1 vaccine for their baby by the end of March 2010 (n=171)

21

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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New Mothers’ Discussions About Get H1N1 Vaccine for their Infants

Getting the H1N1 Vaccine While Breastfeeding

with Health Care Provider

New mothers who have breastfed discussing getting the H1N1 vaccine while breastfeeding with HCP*

HCP Recommendation**

*n=441

**n=123

22

Harvard Opinion Research Program, Harvard School of Public Health, January 26-February 26, 2010.


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