Interventions to increase uptake of influenza vaccination in pregnancy: A systematic review and meta-analysis

BackgroundMaternal influenza vaccination has been introduced in several countries to prevent influenza-related morbidity and mortality in pregnant women, fetuses, and infants too young to be vaccinated. ObjectivesTo analyze the available randomized controlled trials (RCTs) on the effectiveness of pregnant women-focused interventions to increase influenza vaccination uptake during pregnancy. Search StrategyMedline, CINAHL, Scopus, Web of Science, and Cochrane Trial were searched on August 25, 2021. Selection CriteriaRCTs assessing the effectiveness of pregnant women-focused interventions in increasing influenza vaccination among pregnant women were included. Data Collection and AnalysisTwo independent reviewers extracted data. A random-effects meta-analysis was conducted to estimate pooled odds ratios (ORs). Main ResultsSeven RCTs were selected. Overall, the interventions had a significant effect in increasing influenza vaccination during pregnancy compared with standard care (OR 1.78, 95% confidence interval [CI] 1.25-2.54; P = 0.001; I-2 = 67%). However, subgroup analysis suggested that influenza vaccination uptake only was associated with educational interventions (OR 2.71, 95% CI 1.93-3.81; P < 0.001; I-2 = 0%). ConclusionsWe found that several educational interventions for pregnant women can effectively increase influenza vaccination uptake in this population. Specifically, pamphlets, websites, and brief one-to-one education can be effective tools. RegistrationCRD42021269478.