Seasonal Influenza Vaccine During Pregnancy: Uptake, Knowledge, Attitudes and Perceptions in Al-Karak Governorate, Jordan using HBM

Background: Pregnant women are at an increased risk of developing severe flu and suffering its complications. Many countries recommend annual flu immunization during pregnancy, but in Jordan, it has not been routinely recommended or adopted through local guidelines. Moreover, there is limited data on the influenza vaccine uptake, knowledge, attitudes, and barriers for flu virus vaccinnation during pregnancy. Therefore, this study was proposed to assess flu vaccination rates and associated factors among pregnant women in Al-Karak governorate, south of Jordan, during the 2021-2022 flu season. This study applied the Health Belief Model to investigate factors affecting receiving the influenza vaccine during pregnancy. Methods : A cross-sectional study conducted using a reliable questionnaire on a representative sample of pregnant women who had been pregnant between September and November 2021 (N = 382). The Survey consisted of 5 parts to assess pregnant women socio-demographics, knowledge, uptake rate, attitude and perception as well as factors affecting influenza vaccine uptake. Results: The Influenza vaccine coverage among pregnant women was (8.1%) . An intermediate level of knowledge of influenza and its vaccine was reported among the study participants. There was a statistically significant difference between pregnant women in the vaccinated and non-vaccinated groups in terms of place of residence (p<.001) , educational level (p<.001) and past vaccination history (p<.044) . Predictors of vaccination revealed by logistic regression analysis included urban residence (P013.> OR 5.792) , university and high educational level (p<.005 OR 1.35), in addition to previous vaccination (p<.022 OR 2.6) . Other predictors revealed by the Health Belief Model (HBM) were the perceived severity of influenza, perceived benefits of vaccinations, perceived barriers to vaccinations, cues to action and attitudes toward influenza vaccine. Conclusions: This study provides baseline data necessary to develop strategies for increasing flu vaccination rates aiming to reduce flu burden during pregnancy in the south of Jordan.